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Claimant information
For payment of your claim, please complete the below
Select your claim type (select one)
Claim Type
Claim details
Upload your receipt/evidence
Declaration
"I confirm that the information shown on this form and any accompanying documentation is true and
correct. If submitting any information on behalf of another person covered by my policy, I confirm
that I am doing so with their knowledge and permission."
If you have any further evidence to submit that cannot be attached please email it to customerservices@myhealthxtras.co.uk