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Get InterGlobal Claim Form for Medical Treatment Reimbursements 2018-2024

H patient, for each medical condition treated. Sections A to D and section F have to be completed by the patient, or the main member on behalf of the patient if the patient is a dependant under the age of 18. Section E has to be completed by the patient’s medical practitioner, specialist or therapist, unless the claim is for a repeat prescription for medication to treat a chronic medical condition and we have previously approved and paid claims for the same medication to treat the same chronic.

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