Get Your Extras And Medical Claim Form - Bupa

Filling out the YOUR EXTRAS AND MEDICAL CLAIM FORM - Bupa online is a straightforward process designed to assist users in submitting their claims efficiently. This guide provides detailed step-by-step instructions to help you complete the form accurately and ensure you receive your benefits without delay.

Follow the steps to complete your claim form online.

1. Use the ‘Get Form’ button to obtain the form and open it for filling.
2. Begin by completing Section A, which requires your membership number, surname, date of birth, and first name. Ensure to use black ink and capitalize the letters.
3. In Section B, provide your contact address for the claim. Fill in your home phone, postal address, work phone, mobile, and email address. If you want to update the postal address for your membership, tick the appropriate box and ensure the policyholder signs.
4. In Section C, indicate how you wish to receive your benefits by crossing the appropriate box. Supply your bank account details if needed, including account holder names, BSB number, and bank account number.
5. Complete Section D by detailing your claim information. Cross the box confirming whether the claim involves an inpatient hospital stay or is due to an accident. Provide necessary dates and conditions if applicable.
6. Section E inquires if you can recover costs from other sources. Cross the appropriate box and provide explanations if you answered 'yes.'
7. In Section F, read and sign the declaration, ensuring you acknowledge Bupa's terms regarding personal information and benefits. Please make sure to include the date of your signature.
8. Before sending the form, ensure all relevant sections are filled out and signed. Enclose original receipts if required. Finally, send your claim form to the specified address or email the form if applicable.

Complete your claim form online to ensure a swift and smooth process.