Get Group Income Protection Claim: Declaration Of Long Term Incapacity

Filling out the Group Income Protection Claim: Declaration Of Long Term Incapacity form is a vital step in seeking support for your incapacity. This guide provides clear and comprehensive instructions to help you complete the form accurately online.

Follow the steps to complete the form effectively.

1. To begin, press the 'Get Form' button to access the Group Income Protection Claim: Declaration Of Long Term Incapacity form in an editable format.
2. Enter the scheme name or individual policy number in the designated field at the top of the form. This information helps identify your claim.
3. Complete the personal details section by providing your full name and title, address, postcode, and telephone number. Ensure all information is entered in block capital letters.
4. In the next fields, you will need to provide information regarding your height and current weight. Use either feet and inches or centimeters for height, and stones and pounds or kilograms for weight.
5. Detail your occupation prior to your incapacity, stating your job title or role clearly.
6. Describe the nature of your incapacity. Include specific details about your illness or injury and attach additional sheets if necessary for more information.
7. In the current daily activities section, outline how you spend your time, mentioning any relevant activities like shopping or physiotherapy.
8. Fill in your weekly routine, indicating your activities for each day of the week, separating them into AM and PM.
9. Detail any treatments you are currently undergoing, providing as much information as possible for clarity.
10. List the medication you are currently prescribed, including the name, dosage, and frequency.
11. Indicate the status of your condition by checking the appropriate box: deteriorating, improving, or stable.
12. If applicable, mention any thoughts about pursuing other treatment options or returning to work. Attach additional sheets if needed.
13. Provide the names and addresses of your General Practitioner and any consultant or specialist you have consulted regarding your condition.
14. Answer whether you are receiving State Incapacity Benefits, and if no, explain the reason.
15. State if you are receiving an early retirement pension and provide the related details, including the date and amount.
16. Indicate if you are receiving benefits or income from other sources and elaborate on these details.
17. Answer whether you have followed or are currently following any occupation since your absence. If yes, provide job details and dates.
18. Clarify if you are actively seeking employment, and provide further details if applicable.
19. In the declaration section, confirm that the statements provided are true and complete. Sign and date the form before submitting it.
20. Finally, you can save your changes, download, print, or share the completed form as necessary.

Complete your Group Income Protection Claim: Declaration Of Long Term Incapacity form online today to ensure timely processing of your claim.