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Application for Group Scheme Members

 
    If you are a member of an underwritten Group scheme, which is currently insured with Allianz Worldwide Care, you can apply for cover by completing one of the attached forms. You will need to quote the group name and number on the form. These details are available from your employer.

 
     
 


If there is not sufficient space on these forms for all your dependants, please use a second form. Also, please ensure that you and all your dependants sign the form, then mail it to Allianz Worldwide Care at the address mentioned on the form.

If you have any questions or queries, please contact our Group Management Centre.
             
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