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Medical Certificate AXA Travel Insurance Claim Ref: PO Box 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the Full Name of the Patient and their Date of Birth in the specified fields. Ensure accuracy as this information is crucial for processing your claim.
  3. Indicate whether you are the regular medical attendant. If yes, provide the duration of your attendance; if no, explain your involvement with the patient.
  4. Clearly state the precise nature of the medical condition or injury that has led to this claim. If applicable, describe how any injury occurred.
  5. Answer questions regarding past similar conditions and provide specific dates for onset, first consultation, and any serious deterioration.
  6. Detail any ongoing medical conditions and prescribed treatments prior to booking the trip, including consultation dates.
  7. Complete all remaining sections accurately, ensuring that each question is answered fully without using ticks or dashes.
  8. Once completed, review all entries for accuracy before signing and returning the form to the specified PO Box address.

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Insurance company carrier codes

Claims Office COASTWISE. MEDICAL PLAN PO BOX. AXA ASSISTANCE FLORIDA PANAMA CANAL AREA BENEFIT PLAN. ELL AVE, SUITE 1660 MIAMI Florida 33131 8004248196

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CISI

Medical, travel and technical support. Phone #: 1-800-414-0596 Submit claims to: Aetna, P.O. Box 981543, El Paso, TX 79998-1543. Email a copy to

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