Online claim - Health

Thank you for submitting your claim online. Please note that the declaration at the end of this online form must be read and accepted by each policy owner and the claimant (or their parent/guardian if under 16) before it’s submitted. The policy owner(s) will be notified about this claim.
  • Please complete the following checklist to ensure we have all the necessary information to process your claim as quickly as possible.

    An answer is required for this question
    • An answer is required for this question

    • Please attach a document
    An answer is required for this question
    • Initial consultation date
    • History of condition
    • Treatment received
    An answer is required for this question

    BEFORE SUBMITTING YOUR CLAIM, PLEASE DOWNLOAD THE FOLLOWING FORM WHICH NEEDS TO BE COMPLETED BY A REGISTERED MEDICAL PRACTITIONER.

    Medical (Health) Certification Form PDF 123kb

    ATTACH MEDICAL CERTIFICATE OR REFERRAL LETTER

    • Please attach a document
    An answer is required for this question

    Attach ACC decision letter

    • Please attach a document
    An answer is required for this question
  • Invoice Amount ($)
  • Here is the validation / error message
  • Please attach a document
  • $0 Sum of Invoices

  • Sum of Invoices must be greater than $0
  • Receipt Amount ($)
  • Please attach a document
  • $0 Sum of Receipts

  • Sum of Receipts must be greater than $0
  • $0

    Total value of claim

  • Name of account is required
  • Bank account is required Bank account is invalid
(Please ensure the total size of all attached files does not exceed 10MB)

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NEED HELP WITH YOUR CLAIM?

Call us on 0800 500 108

or +64 9 487 9000

Attachment hints

Total file size for all attachments can not exceed 10MB.

Only file of type: DOC, PDF, JPG/JPEG or PNG is allowed as attachment.

Disclaimer: The availability of any insurance cover is subject to your application being approved. For full details, refer to the policy document which is available on request from Sovereign. Applications are subject to individual consideration. Special conditions, premiums, maximums and exclusions may apply.