IFCR

IFRC

Please use your business email address (@ifrc.org)

Patient informations:

Costs informations

Nature of medical cost

if your claim form contains invoices from different years it will be refused!
Do not add up invoices in one line "Nature of medical cost" needs to be precise invoices more than one year old (invoice date) will not be reimbursed

Please attach copies of invoices and medical prescriptions related to this claims (scanned PDF File only).The original documents must be stored 1 year in case of control of the insurance.

Invoice 1

Invoice 2

Invoice 3

Invoice 4

Invoice 5

Invoice 6

Invoice 7

Invoice 8

Invoice 9

Invoice 10

Invoice 11

Invoice 12

Documents

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