Declaration of another recipient/beneficiary

Targetaudience
Insured
Editor
Caisse nationale de santé (CNS)

Declaration of another recipient/beneficiary

Language : English
Pdf - 461 Kb - 1 page(s)

Any third party who can prove that they have paid healthcare expenses on behalf of an insured person is entitled to claim reimbursement for the part of their expenses that are covered by the CNS.

This form allows the third party intervener to request the refund on his personal account.

More languages :

Déclaration autre bénéficiaire pour intervenant tiers

Language : French
Pdf - 45 Kb - 1 page(s)

Zahlungsempfänger-Erklärung

Language : German
Pdf - 43 Kb - 1 page(s)
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