Submit Your Private Health Insurance Details Submit Your Private Health Insurance Details Health Insurance Form For Returning ClientsAuthorisationPolicy Excess Personal Details Consent to ProceedTakes ~ 3 minEnter Your Details to Activate Your Insurance Cover⚠️ Your details must match your insurance policy exactly. Incorrect details will cause claim rejection, and invoices will be sent directly to you.MEMBERSHIP / POLICY NUMBERCONFIRM MEMBERSHIP / POLICY NUMBERAUTHORISATION CODE CONFIRM AUTHORISATION CODE NUMBER OF APPROVED TREATMENTSUPPER PAYMENT LIMIT (£)MEMBER’S SESSION CONTRIBUTION (%)BODY PART- Select -Head / NeckShoulder / Upper ArmElbow / ForearmWrist / HandBackHip / GroinUpper LegKneeLower LegFoot / Ankle I confirm all details match my insurance policy exactly. If any information is incorrect or incomplete, I will be responsible for all charges. ➡️ Click ‘Next’, you’re almost there.PreviousNextConfirm Your Policy ExcessKnowing your excess now means you won't incur any unexpected charges. Your excess is the amount you’ve agreed to pay personally before your insurer starts covering your treatment costs. For example, if your excess is £100, you’ll cover this first £100 yourself, and then your insurer will pay the rest.CONFIRM YOUR EXCESSImportant Confirmation Please confirm that you understand you will be responsible for any shortfall not paid by your private medical insurance provider. This may include: Insurance policy excess Unpaid invoices Treatment session underpayments I confirm that I am responsible for covering any excess, unpaid invoices, or shortfalls not covered by my insurer.FAQ & SupportWhat is an insurance excess? An excess is your agreed contribution toward treatment costs. It’s set when you take out your insurance — usually between £50 and £250 — and applies once per policy year. How do I find out my excess? You can check this quickly by logging into your insurer’s online portal or calling them directly. Most clients find out in under 5 minutes. How do I pay my excess, unpaid invoices, or shortfalls not covered by my insurer? If any invoices are unpaid or there is excess to pay, we’ll send you a secure payment SMS link to settle the balance.➡️ Click Next finalise your booking.PreviousNextYour Personal Details⚠️ Your details must match your insurance policy exactly. Incomplete or incorrect details (e.g. nicknames or missing street name or postcode) will cause claim rejection, and invoices will be sent directly to you.TITLE- Select -MsMissMrDrProfMxSirDameRevFrRabbiImamPastorLordLadyFIRST NAMEMIDDLE NAMELAST NAMEDATE OF BIRTHEMAILPHONE NUMBERYOUR ADDRESSAddress Line 1Address Line 2CityState / ProvinceZIP / Postal codeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe I confirm all details match my insurance policy exactly. If any information is incorrect or incomplete, I will be responsible for all charges.PreviousNextConsent to ProceedBy undergoing treatments, you give explicit consent for One Body LDN to communicate with your GP, consultant, or private medical insurance company if needed, for the purpose of requesting further treatment sessions or discussing relevant medical information in your best interests. I confirm I give consent for One Body LDN to liaise with my GP, consultant, or insurer regarding my treatment when necessary. Previous Submit Insurance Details
