Get Allianz Worldwide Care

This guide is designed to help you navigate the process of filling out the Allianz Worldwide Care claim form online. By following the steps outlined below, you can ensure that your form is completed accurately and submitted in a timely manner.

Follow the steps to complete your claim form successfully.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by filling out the Policyholder Details section. Provide your insurance number, title, surname, first name(s), correspondence address, daytime phone number, evening phone number, fax number, and email address.
3. Next, complete the Patient Details section. Include the patient's title, surname, first name(s), date of birth (in the format dd/mm/yy), and indicate whether the claim is related to an accident by selecting 'Yes' or 'No'.
4. Proceed to the Payment Details section. Here, decide on the method of payment. Choose either Option 1 for payment to the policyholder or insured, or Option 2 for payment to the provider of medical services. If selecting Option 1, provide the invoice currency and preferred payment method, including bank transfer details if applicable.
5. In the Patient Signature & Release section, certify that the information provided is accurate. The patient (or a parent/guardian if applicable) must sign and date the form (dd/mm/yy) to confirm this.
6. Attach all relevant original invoices to the completed form. Note that photocopies, receipts, and credit card slips are not accepted.
7. If invoices from Germany or the USA are being submitted, remember that the reverse side of the form does not need completion. Simply attach the original invoices.
8. Finally, keep copies of all documents submitted for your records. Once everything is completed, post the form to the address provided at the end of the document.

Submit your completed Allianz Worldwide Care claim form online today!