Get Contact Us International Claim Form - Bankmed - Bankmed Co

Filling out the Contact Us International Claim Form for Bankmed is a vital step for users seeking to claim medical expenses incurred while traveling abroad. This guide provides detailed instructions to assist you in completing the form accurately and efficiently.

Follow the steps to complete the International Claim Form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Carefully fill in your travel and personal information in section one. Begin by entering your membership number, departure date, and return date. Indicate whether you purchased your ticket using a credit card, and if so, provide the name of your bank. Also, declare if you have independent travel insurance and provide personal details such as the patient's surname, first names, date of birth, postal and physical addresses, and contact numbers.
3. In the second section, you'll need to detail any medical aid-related expenses incurred. Provide the date of illness, injury, or hospital admission, along with the country where the incident occurred. Describe the cause of your illness and treatment received, including the name of the hospital and the total amount claimed in foreign currency. Be sure to answer whether you settled these accounts yourself and if you had received previous treatment for the same condition in South Africa.
4. Move to section three, where you must list details of your treating doctor in South Africa. Include the doctors' names, telephone and fax numbers, and relevant email addresses. You should also provide a brief explanation of the medical incident along with dates of admission and discharge and treatment details.
5. Complete the declaration in section four by confirming that all particulars entered are true. You will need to print your name in full, provide your signature, and date the form.
6. Once all sections are completed, review your document to ensure accuracy. After finalizing your form, save your changes, then choose to download, print, or share the completed form as necessary.

Complete your Contact Us International Claim Form online now to ensure a smooth claims process.