Get 1411 - 14 Group Combined Claim Form A4 - Edgars

The 1411 - 14 Group Combined Claim Form A4 - Edgars is an essential document for submitting various types of claims, including funeral, personal accident, retrenchment, and disability claims. This guide will help you navigate the process of filling out the form online with clear instructions for each section and field.

Follow the steps to complete your claim form efficiently.

1. Click the 'Get Form' button to access the 1411 - 14 Group Combined Claim Form A4 - Edgars and open it in your preferred online editor.
2. Begin by selecting the product for which you are making the claim. Choose from options like APP, APPP, APP + Funeral, Commuter Travel, Personal Accident, etc.
3. Select the reason for the claim from available options such as Death/Funeral, Permanent Disability, or Retrenchment. Ensure to enter the date of the event accurately.
4. In Section A, fill in your account number, policy number, surname, full name, identity number, and telephone contact details. It is essential to provide accurate information.
5. If applicable, complete Section B with the details of the deceased, including their name, identity number, cause of death, place of accident, and related details.
6. In Section C, if you are filing for retrenchment, provide information about your former employer, including company name, address, and contact details. Include the date of retrenchment.
7. For Permanent Disability or Personal Accident claims, complete Section D by providing the date of disability and the cause. If it was caused by an accident, include relevant police details.
8. Section E is for claimant information if you are not the account holder. Input your surname, full names, identity number, and relationship to the deceased.
9. In Section F, if applicable, enter payment details such as the name of the account holder, bank name, branch code, account number, and type of account.
10. Complete Section G by signing to consent for sharing and accessing relevant information pertaining to your claim. Make sure to date your signature.
11. After filling out all required fields, carefully review your entries for accuracy. Save changes, download the form, or print it for submission.

Start completing your 1411 - 14 Group Combined Claim Form A4 - Edgars online now to ensure your claim is processed smoothly.