I want to submit a new claim

Tell us what’s happened, and we’ll get your claim moving

Make a claim on MyAviva

You can make a claim for yourself through MyAviva where you could benefit from an instant decision. Here you can also see details of any benefit limits, policy terms and conditions, previous claims and your billing history. 

If you have accessibility needs and would like to get in touch in another way, please visit our accessibility support page.

Sorry, you need to enable JavaScript to use this form. If you are unable to do this, please return to our contact us page to find the relevant telephone number.

Your details

Policy number

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

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

(Please ensure you select the correct DOB including the year. If this doesn’t match our records, we won't be able to complete the claim.)

We'll use this to contact you about the claim.

Is this claim for yourself?

(Please ensure you select the correct DOB including the year. If this doesn’t match our records, we won't be able to complete the claim.)

Details of the claim

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

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

If you/they can’t remember the exact date, please give a best estimate

Have you/they previously had symptoms similar to this, in the same area or related to the current symptoms?

If you can't remember the exact date, please give us your best estimate. Please use the date format MM/YYYY

Have you/they had ongoing treatment, investigations or consultations?

Please tell us anything else you/they think is relevant about the issue you/they need to claim for, such as:

  ·   Any treatment or medication you've/they've previously had for this

  ·   Any associated medical conditions you/they suffer from.

  ·   Any medication you're/they're currently taking

If you've/they've been asked to specify further information about the type of referral you've/they've had, or who has made this referral, please do so here.

Do you/they wish to be seen at a specific hospital?

Choose 'No' if you're happy to consider all suitable options in your area.

For example, 'Spire Norwich Hospital'. We’ll aim to meet your preferences wherever possible, subject to your policy terms and conditions

For example, 'John Smith'. We’ll aim to meet your preferences wherever possible, subject to your policy terms and conditions. 

Do you/they have any additional support requirements you/they would like to make us aware of?
Please select from the following

Next steps

There's no need to call. We'll email you within 2 working days regarding the claim. We'll only call if we need to discuss something further

Declaration

Aviva uses your personal data as set out in our Privacy Policy. We use Google’s reCAPTCHA technology to protect our websites from spam and abuse. The Google Privacy Policy and Terms of Service apply to reCAPTCHA.

If you have accessibility needs and would like to get in touch in another way, please visit our accessibility support page.