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DECLARATION BY THE INSURED: I hereby declare that the information furnished in this claim form is true & correct to the best of my knowledge and belief. If I have made any false or untrue statement, suppression or concealment of any material fact with respect to questions asked in relation to this claim, my right to claim
If you have any queries about your claim contact our Customer Services team on: Telephone +44 (0) 1273 323563 Fax +44 (0) 1273 820517 E-mail; info@bupa-intl.com. Return this form with original invoices to: BUPA International, Russell Mews, Brighton BN1 2NR, United Kingdom. Email is used for your convenience and
Please complete all the relevant sections of the claim form using BLACK INK and write within the boxes with CAPITAL LETTERS. Mark all appropriate boxes with a CROSS (X). All areas marked with an ASTERISK (*) must be completed. Claims must be submitted within 2 years from the date of service. If you are an Overseas
IMPORTANT INFORMATION. Return this form with original, or copy invoices via email, fax or post to; info@bupa-intl.com, Fax: +44 (0) 1273 820 517, or post: Bupa Global, Victory House, Trafalgar Place, Brighton, BN1 4FY, UK. Claims can also be submitted as eClaims via Membersworld. Please ensure that all sections of
The form should be returned to us within six months of Fill & Sign Online, Print, Email, Fax, or Download. Fill Online. Excellent reviews. Form Popularity bupa international claim form pdf. Fill Online. eSign. Fax. Email. Add Annotation. Share. Bupa Claim Form is not the form you're looking for? Search for another form here.
Frequently-used forms. Hospital Claim form (pdf, 1.65 MB) · Clinical Claim Form (pdf, 1011.5 Kb) · Pre-authorisation Form (pdf, 624.49 Kb). For members of Bupa CarePro, Bupa Care Kid, Bupa Together, Bupa HealthPlus and Bupa Transfer Care. Declaration of Membership Card Loss Form (pdf, 88 Kb)
To claim by mail, download and print out a claim form, complete it, attach the original account(s) you received from your healthcare provider - and the Download a claim form (PDF, 30KB) The status of your claim; How to fill in a claim form; What documents you need to attach to your claim form.
IMPORTANT INFORMATION. For quicker handling of your claim, simply log in to your Membersworld account and either complete a digital version of this claim form, or complete the mandatory fields as shown on the 'submit a claim' section. Alternatively, you can return this form with original, or copy invoices via email to:
Bupa International. Claim form. Return this form with original invoices to: Bupa International, Russell House, Russell Mews, Brighton BN1 2NR, United Kingdom. Please ensure that all sections of the claim form are fully completed. Note that claims payment may be delayed if all sections of the claim form are not completed in
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March 2018