Get Westfield Claim Form

Filling out the Westfield Claim Form online can streamline the process of submitting your health claims efficiently. This guide will walk you through each section of the form so you can complete it accurately and confidently.

Follow the steps to complete the Westfield Claim Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by circling your title from the options provided, such as Mr, Mrs, Miss, Ms, Dr, or Other.
3. Enter your Westfield account number, surname, first name, and date of birth in the designated fields.
4. If your address has changed, place a cross in the provided box and fill out your new address, including house number/name, street, town, and postcode.
5. Provide your contact telephone number and mobile number in the respective fields.
6. If you wish to receive your payment directly into your bank account, enter your account number and sort code. If these details are unchanged, you can skip this section.
7. In the declaration section, confirm that all information provided is true and sign the form with the policyholder's signature and date.
8. If your premiums are deducted from your wages, include the necessary information about your employer, department, and payroll number.
9. Place a cross in the box next to the benefits you are claiming, such as optical or dental benefits, and provide the amount claimed.
10. For each claim, ensure you enclose the relevant original receipted account that clearly displays the practitioner's name and address.
11. Complete the receipt dates for each claimed service and include the name of the doctor who recommended the treatment.
12. Review the form for completeness, then save your changes, download the form, print it, or share it as necessary.

Get started on your claims process by completing the Westfield Claim Form online today!