Administration Forms

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Application Forms

Health Insurance Applications

comprehensive international plan application Download  pdf

standard international plan application Download  pdf

premier international plan application Download  pdf

major medical plan application Download  pdf

physician examination report Download  pdf

Travel Insurance Applications

pci bon voyage travel application Download  pdf

pci annual travel plan application Download  pdf

Claim Forms

Health Insurance Claim Forms

notification of inpatient/outpatient claim form Download  pdf

dental claim form Download  pdf

oral examination report Download  pdf

Travel Insurance Claim

travel insurance claims form Download  pdf

Treatment Plans

referral for follow-up care Download  pdf

treatment plan for chemotherapy and radiotherapy Download  pdf

treatment plan for physiotherapy, chiropractic and acupuncture Download  pdf

Policy Documents

policy document medical policy Download  pdf

policy document annual travel plan Download  pdf

policy document bon voyage plan Download  pdf

Premium Payment Form

payment method Download  pdf