Refund of premium

If we've contacted you to request your bank account details so we can refund premium, please complete the form below.


You must be the policyholder or have authority to make changes to this policy. Please ask the policyholder to get in touch or they can complete a policy authorisation form.

Please provide your bank account details for this payment


Note: The bank account details provided here will only be used for remediation payment.

Enter your personal details

These details help us verify who you are so we can deal with your enquiry as quickly as possible.

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By submitting this form, you acknowledge and agree that personal and health information provided to us (including any supporting documents) will be collected, stored, used and disclosed in accordance with the terms of our Member Privacy Statement.