Your Personal Details

First name*

Surname*

Address*

Telephone number

Mobile phone number

Membership Number

Claim Details

Hospital Stay Benefit
To claim for a hospital stay, please upload a copy of your discharge letter.

Date (s) of hospital stay:

Date From*

Date To*

Reason for admission to hospital*

Copy of Hospital discharge letter

Payment Details

Payment will be made directly into the bank account we hold on record for you below. If the section is blank please provide details of the bank account you wish to receive payment.

Account number*

Sort code*

Claimant declaration and consent

I declare that I am not claiming for this claim under another health insurance product
I understand that any fraudulent claims may result in legal action being taken and immediate cancellation of my policy
I consent to ASFS processing any health and medical information contained in this form in order to pay my claim
I authorise any medical practitioner or other person(s) concerned with providing healthcare to give you any information relevant to this claim
I declare the information shown on this form and any accompanying documentation is true and complete

Digital signature: Please type your full name into this box

Privacy Notice

Anglo-Saxons Friendly Society Ltd acts as the data controller in respect of your personal data. We take your privacy seriously and we will receive, process and store data, including your personal data, to enable us to provide you with the services that we offer and for all other purposes consistent with the proper performance of our operations. For our full statement on data protection and privacy, click on ‘Privacy Policy’ at the bottom of the page.

Email verification

To complete your claims submission:

Press the green verification code button below
We will send a verification code to the email address used on this claim form
If the email address is incorrect or blank please contact our membership support team on 01474 567050 or email us at info@anglo-saxons.co.uk and we will update your membership contact details.
Copy and paste or key in the verification code from the email into the verification code box below and press submit.

Verify Code (required)

Cookie Policy

Cookies

A cookie is a small file which asks permission to be placed on your computer’s hard drive. Once you agree, the file is added and the cookie helps analyse web traffic or lets you know when you visit a particular site. Cookies allow web applications to respond to you as an individual. The web application can tailor its operations to your needs, likes and dislikes by gathering and remembering information about your preferences.

We currently operate an ‘implied consent’ policy, i.e. we assume you are happy with our use of cookies. If you are not happy, then you should either not use this site, or you should delete our cookies once you have visited the site, or you should browse the site using your browser’s anonymous usage setting (called ‘Incognito’ in Chrome, ‘InPrivate’ for Internet Explorer, ‘Private Browsing’ in Firefox and Safari etc.)

We use traffic log cookies to identify which pages are being used. This helps us analyse data about webpage traffic and improve our website in order to tailor it to customer needs. We only use this information for statistical analysis purposes and then the data is removed from the system.

Overall, cookies help us provide you with a better website by enabling us to monitor which pages you find useful and which you do not. A cookie in no way gives us access to your computer or any information about you, other than the data you choose to share with us.

You can choose to accept or decline cookies. Most web browsers automatically accept cookies, but you can usually modify your browser setting to decline cookies if you prefer. This may prevent you from taking full advantage of the website.

If you don’t want to receive cookies, you can modify your browser so that it notifies you when cookies are sent to it or you can refuse cookies altogether. You can also delete cookies that have already been set.

If you wish to restrict or block web browser cookies which are set on your device then you can do this through your browser settings; the Help function within your browser should tell you how. Alternatively, you may wish to visit www.aboutcookies.org, which contains comprehensive information on how to do this on a wide variety of desktop browsers.

Cookies on this website

Session cookies – We use a session cookie to remember user log-ins for you when logging into our website. Session cookies may also be used to store shopping cart data, recently viewed items, or an authentication across multiple pages.
You can learn more about session cookies and what they are used for at http://www.allaboutcookies.org/cookies/session-cookies-used-for.html

Google Analytics – we use this to understand how the WWW.ANGLO-SAXONS.CO.UK site is being used in order to improve the user experience. Your user data is all anonymous. You can find out more about Google’s position on privacy as regards its analytics service at http://www.google.co.uk/intl/en/analytics/privacyoverview.html