I want to submit a new claim for someone on my policy

Fill in your details below

If the claim is for someone named on your policy, you can submit it on their behalf. Once you’ve submitted, we’ll either email you or contact them directly within two working days.

We’ll need a few details about you and the person you're claiming for.

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Your details

It’s important that you include this as it helps us identify your policy.

Please enter the date in the format dd/mm/yyyy

If the email address you give us isn’t the one we already have for you, we’ll get in touch by phone or post

Details of the person you're claiming for

Please enter the date in the format dd/mm/yyyy

Please include their email if they are over the age of 16

Please include their number if they are over the age of 16

Claim details

Now we'll need some details about the claim.

Does the issue affect the left, right or both sides of their body?

Please provide as much detail as possible around how this is affecting their daily life

Please enter the date in the format dd/mm/yyyy

Is this the first time they’ve had these symptoms?

Please enter the date in the format dd/mm/yyyy

Has there been any ongoing symptoms, consultations, investigation and/or treatment relating to the condition being claimed for?

Please tell us anything else you think is relevant or important

Such as having your documents in an alternative format or that you require additional support with communications (e.g. a translator or being hard of hearing).

We will update this on your client record for your health policy with Aviva

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