Claim Form - Cancellation/curtailment
ADVERTISEMENT
1
2
3ACE European Group
CL IM FORM
Claims Department
PO Box 4511
Dunstable LU6 9QA
Cancellation / Curtailment
tel: 01 440 1700
fax: 01 440 1701
e-mail:
PLEASE WRITE IN BLACK INK AND USE BLOCK CAPITAL LETTERS.
ALL SECTIONS MUST BE COMPLETED OR MARKED ‘NOT APPLICABLE .
COMPLETE THE CHECKLIST AND ENSURE THAT YOU SIGN THE DECLARATION AT THE END OF THIS FORM.
Name of Policyholder
Certificate/Policy no.
Insured Person forename(s)
Insured Person surname
(Mr/Mrs/Miss/Ms)
Full address
Postcode
Date of birth
Telephone no.
Telephone no.
business
home
E-mail address
Full name of claimants
Date of birth
Relationship to Insured Person
(DD/MM/YYYY)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal