Get Allianz Worldwide Care Claim Form

Filing a claim can be a straightforward process if you have a clear guide. This comprehensive overview will assist you in filling out the Allianz Worldwide Care Claim Form accurately and efficiently online.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to obtain the claim form and open it in the editor.
2. Begin by completing the policyholder's details section. Fill in your policy number, select your title, and provide your first name, surname, date of birth, and correspondence address. Indicate if this is a new address and whether you wish to receive all future correspondence there.
3. Next, provide patient details. Confirm if the patient is the same as the policyholder by selecting Yes or No. If No, fill in the patient's first name, surname, and date of birth.
4. In the payment details section, choose your preferred payment method. If selecting payment to the medical provider, ensure to specify whether you want a cheque or direct bank transfer, and provide the necessary banking information if applicable.
5. Sign and date the patient signature and release of medical records section, confirming that no false information has been provided. Include the date of the signature.
6. Complete the claim details section. Indicate the country where treatment occurred, whether it's a result of an accident, and provide any relevant details about other insurance policies that may cover the incident.
7. Fill in the invoice table accurately with the description of the expense, provider's name, amount charged, and state whether the bill has been paid.
8. If applicable, have your treating medical provider complete the medical provider’s details section, including their name, qualifications, and other requested information.
9. Fill out the medical details section, providing full details of the patient's condition and any necessary codes for accurate processing.
10. Finally, attach original receipts and invoices to the completed claim form, ensuring all sections are filled out completely and correctly. Review all details before proceeding to save, download, print, or share the claim form.

Take the next step and complete your Allianz Worldwide Care Claim Form online.