Make a claim

To make a claim simply fill out this form and a member of the team will be in touch with you.

*required fields

Your Name *

Your Email *

Contact Number *

Your Policy Number

Is this a new claim or an ongoing claim which started prior to commencing cover with H3?

What is the nature of your claim?Please provide a summary of symptoms experienced, including when they started

Do these symptoms relate to any other medical condition you may have had in the past?(If so please indicate)

Have you consulted a doctor regarding these symptoms

If you have consulted a doctor, what recommendations were made?Please describe any treatment received/provided to date including details of any medications prescribed, or tests conducted

If a specialist has been recommended, please indicate the name of the specialist below

How would you prefer to be contacted?

When would you prefer to be contacted?

Please read the following disclaimer before proceeding: This claim notification service is to try and direct you to the appropriate specialist as quickly as possible. Any advice given or action taken as a result of the information provided to us is done so in good faith without the benefit of a physical examination. It is based solely on the information provided to us and therefore we are not liable in respect of any advice provided. Should you condition deteriorate before you are seen or contacted by us, we recommend that you go to your nearest accident and emergency department or contact your local GP service. Please do not arrange any treatment or appointments without prior authorisation from H3. Failure to do so may result in a claim not being paid.