Submit your claim online

Submit your insurance claim online by completing the form below. This service is only avilable to Bupa Global members with a health insurance policy.

Once the claim has been submitted, you will receive an email as proof of submission.

Please remember to:

• upload information of diagnosis if possible
• make sure the claims you wish to upload are the correct file type (gif, tiff, jpeg, pdf)
• keep your original bills and receipts until your claims have been processed

If you have any questions, please visit the FAQ or contact us by email or phone (+45 33 15 30 99).

Personal information

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Policy number *

Date of birth *

First name(s) *

Last name *

Email *

(Confirmation will be sent to this email address)

                     

Health information

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Diagnoses *

enter all diagnoses related to claims

   

Insurance information

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Do you have a health, travel or accident insurance with another insurance provider? *

 

Yes
No

Company name *

Policy number *

     

Payment information

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How would you like your claim to be paid? *

 

Credit card
Bank transfer
Cheque

Use as partial premium payment

Use my reimbursement as partial or full settlement of any outstanding premium on my policy or as prepayment of the premium for the upcoming insurance period.

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Select card type *

Mastercard / Eurocard
Visa
JBC

Credit card no *

Expiry date *

Currency *

Select currency CHF - Swiss Franc DKK - Danish Krone EUR - Euro GBP - Great British Pound HKD - Hong Kong Dollar JPY - Japanese Yen NOK - Norwegian Krone SEK - Swedish Krona USD - US Dollar

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Name of bank *

Address *

BIC/SWIFT code/ABA, if any *

IBAN no. *

Account no. *

Currency *

Select currency AED - Arab Emirate Dirham AUD - Australian Dollar CAD - Canadian Dollar CHF - Swiss Franc DKK - Danish Krone EGP - Egyptian Pound EUR - Euro GBP - Great British Pound HKD - Hong Kong Dollar HUF - Hungarian Forint IDR - Indonesian Rupiah JOD - Jordanian Dinar JPY - Japanese Yen MXN - Mexican Peso NOK - Norwegian Krone NZD - New Zealand Dollar PLN - Polish Zloty SAR - Saudi Arabian Riyat SEK - Swedish Krona SGD - Singapore Dollar THB - Thai Baht USD - US Dollar ZAR - South African Rand

Account holder *

 

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Please issue the cheque to: *

Currency *

Select currency AED - Arab Emirate Dirham ANG - Dutch Guilder AUD - Australian Dollar BDT - Bangladeshi Taka BHD - Bahraini Dinar CAD - Canadian Dollar CHF - Swiss Franc CZK - Czech Koruna DKK - Danish Krone EEK - Estonian Kroon EUR - Euro GBP - Great British Pound GMD - Gambian Dalasi HKD - Hong Kong Dollar ILS - Israeli Shekel INR - Indian Rupee ISK - Icelandic Krona JOD - Jordanian Dinar JPY - Japanese Yen KES - Kenyan Shilling KRW - South Korean Won KWD - Kuwaiti Dinar LKR - Sri Lankan Rupee MAD - Moroccan Dirham MTL - Maltese Liri MXN - Mexican Peso NOK - Norwegian Krone NZD - New Zealand Dollar OMR - Omani Rial PHP - Philippine Peso QAR - Qatari Riyal SAR - Saudi Arabian Riyat SEK - Swedish Krona SGD - Singapore Dollar THB - Thai Baht TND - Tunisian Dinar TTD - Trinidadian Dollar USD - US Dollar ZAR - South African Rand

                                     

Attach documents

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Attach your bills and related documents one at a time. Click on "Browse", choose the file in the new window and click on "attach". Repeat this for each document you want to attach.
Please make sure that all attachments are legible and not in a secured format.

Attach documents *

(pdf, jpg, tiff, max 10 Mb per file)

All files size

0.00 MB

 

Other information

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Comments

e.g. change of address

 

I would like to sign up as an online customer

As an online customer, I will be notified by e-mail each time new documents are available on my personal site myPage on www.ihi.com. I will no longer receive any hardcopies of my documents and I am responsible for checking all documents and correspondance online.

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Email *

Please enter the email that should be used for email notifications

Terms and conditions

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I have read and accept the terms and conditions *

I declare that all information given is in accordance with the truth, and I authorise Bupa Global and my insurer (if another insurer is indicated in my Bupa Global policy documents) to obtain and exchange information from any hospital, specialist, physician, health provider, transportation company, public authority or insurance company about any diagnosis, test result, treatment or other service provided to or about me or my legally dependant child for the purpose of processing the claim in accordance with the policy condtions.

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