Dental and Cashback Claims

Claim type

Only answer if you've selected 'Dental' for field_G01

Dental claim

Please use this form to make a Dental claim. We'll respond to your query as soon as possible.

Fields marked with a * are required.

Claim details

Only answer if you've selected 'No' for field_D05
Only answer if you've selected 'No' for field_D05
Only answer if you've selected 'No' for field_D13
Only answer if you've selected 'No' for field_D13
Only answer if you've selected 'No' for field_D13
Only answer if you've selected 'Yes' for field_D16

Payment details

Only answer if you've selected 'Yes' for field_D19

We'll use the bank account details we have unless you tell us otherwise. If we don’t hold any, we'll send a cheque.

Payments usually take 4 working days once processed. Cheques will take 7-10 working days.

Only answer if you've selected 'No' for field_D19
Payments by cheque usually take 7-10 working days once processed.

Upload documents*

Please attach your itemised invoice(s), receipt of payment, and DIF if required.

  • There is a 25MB upload limit
  • We cannot accept credit or debit card details online

To upload documents:

  • First, click the white 'Upload a document' button.
  • Click ‘Browse’ and locate the document from your files. This will add the document.
  • If the document has a valid size, name and file format, a green tick will appear.
  • You can attach more documents by clicking the 'Upload another document' button and repeating the process.

Once you've attached everything you wish to send to us, click the red 'Submit' button.

You'll receive an email confirming receipt of your documents, and a contact reference number for you to quote if you need to refer to the message.

Document not accepted?

If your document isn’t accepted, a message will appear to let you know why.

  • If it's too large, you'll need to split it into smaller files, save it in a lower quality, or save it in a different file format. The largest we can accept is 25MB.
  • If the name contains special characters that we cannot accept, you'll need to rename the document using standard alphanumeric characters.
  • If the file format is one that we cannot accept, you'll need to save it in a different format.
Accepted file formats: PDF, Word, Excel, Powerpoint, JPG, PNG, BMP, GIF, TIFF, ODP, ODS, ODT, RTF, TXT.

Login information

To ensure you're the only person who can access this information, we don't store your memorable word in our systems, so we're unable to remind you of your login details.

Your memorable word needs to be between 8 – 20 characters long.
Please ensure that your reminder does not contain your memorable word in anyway. We will provide this information as a prompt to help you to log into the message centre. E.g.
Memorable word: St John's
Memorable word reminder: Name of my first school
You can find independent information about the quality and cost of private treatment available from doctors and hospitals by looking at the Private Healthcare Information Network website at www.phin.org.uk.
Only answer if you've selected 'Cashback' for field_G01

Cashback claim

Please use this form to make a Cashback claim. We'll respond to your query as soon as possible.

Fields marked with a * are required.

Claim details

Only answer if you've selected 'Yes' for field_C01
Only answer if you've selected 'Yes' for field_C02

In the 'Upload documents' section below, please attach a scanned copy of the completed accident form along with your invoice(s).

Only answer if you've selected 'No' for field_C02

Before you submit this form, please complete an accident form, scan it, and attach the scanned copy of the completed accident form along with your invoice(s) in the 'Upload documents' section below.

Only answer if you've selected 'No' for field_C03
Only answer if you've selected 'No' for field_C03
Only answer if you've selected 'No' for field_C11
Only answer if you've selected 'No' for field_C11
Only answer if you've selected 'No' for field_C11
Only answer if you've selected 'Yes' for field_C14

Payment details

Only answer if you've selected 'Yes' for field_C17

We'll use the bank account details we have unless you tell us otherwise. If we don't hold any, we'll send a cheque.

Payments usually take 4 working days once processed. Cheques will take 7-10 working days.

Only answer if you've selected 'No' for field_C17
Payments by cheque usually take 7-10 working days once processed.

Upload documents*

Please attach your itemised invoice(s), receipt of payment, and accident form if required.

  • There is a 25MB upload limit
  • We cannot accept credit or debit card details online

To upload documents:

  • First, click the white 'Upload a document' button.
  • Click ‘Browse’ and locate the document from your files. This will add the document.
  • If the document has a valid size, name and file format, a green tick will appear.
  • You can attach more documents by clicking the 'Upload another document' button and repeating the process.

Once you've attached everything you wish to send to us, click the red 'Submit' button.

You'll receive an email confirming receipt of your documents, and a contact reference number for you to quote if you need to refer to the message.

Document not accepted?

If your document isn’t accepted, a message will appear to let you know why.

  • If it's too large, you'll need to split it into smaller files, save it in a lower quality, or save it in a different file format. The largest we can accept is 25MB.
  • If the name contains special characters that we cannot accept, you'll need to rename the document using standard alphanumeric characters.
  • If the file format is one that we cannot accept, you'll need to save it in a different format.
Accepted file formats: PDF, Word, Excel, Powerpoint, JPG, PNG, BMP, GIF, TIFF, ODP, ODS, ODT, RTF, TXT.
AXA Health, and any intermediary involved, will hold and use the personal data you have given to deal with your enquiry. In sending this email you consent to the use of such personal data. We may also disclose information about you when there is a legal requirement for us to do so or in circumstances when it would help us to prevent fraud or improper claims.