Forms

Send your forms to

Claim forms

Application forms, Direct debit forms and Recurring credit card forms

Southern Cross Health Society
Private Bag 3216
Waikato Mail Centre
Hamilton 3240
Freepost Authority 158217

Southern Cross Health Society
Private Bag 99934
Newmarket
Auckland 1149
Freepost Authority 1440

Prior approval

An online approval form is available here

Claims

A claims form you can print out and submit through the post can be downloaded here

A form for hospital allowance claims can be downloaded here ► and a form for funeral allowance claims can be downloaded here ► 

Direct debit form

A direct debit form where you can update your details can be downloaded here ►

We now offer paperless direct debit, which means you can provide direct debit instructions to us over the phone without having to sign and post a completed form.

In most cases we can arrange this over the phone if you:

  • are the policyholder
  • are named as a bank account holder for the account that you are nominating to use on your policy; and
  • have authority to operate the account you are nominating alone.

There are some situations where we are unable to offer this. Please contact us for more information.

Recurring credit card form

A recurring credit card form where you can update your credit card details can be downloaded here

Please note that changing your payment method may change your premium amount or policy anniversary.
Please email info@southerncross.co.nz or call us on 0800 800 181 if you would like to know more.

Wage & salary deduction form

If you would like to ask your employer to deduct premiums directly from your salary and your work scheme
allows this then you can download the form here

Access authorisation form

You can download a form to authorise access to your policy by another individual here

Contact us

Send us a message here ►

Affiliated Providers

Click here for the latest Affiliated Provider directory

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