The AVIVA LTD Dental Claim Form is a 2-page PDF document used by Aviva insurance policyholders in Singapore to request reimbursement for dental treatments. The form is divided into two sections, each completed by a different party in the dental claim process.
Section I of the Aviva dental claim form is completed by the employee or policyholder. This section collects personal information, insurance details, and bank account information required for direct credit reimbursement.
Required fields in Section I include your full name, Aviva policy or card number, date of birth, and contact phone number. If you are submitting a dental claim on behalf of a dependent, you must specify your relationship to the patient. You are also required to provide your current bank account numbers so that approved reimbursements can be transferred directly to your account. Updating bank account details before submission prevents delays in claim processing and ensures your payment arrives without issues.
Section II of the dental claim form must be completed by the treating dentist or dental professional. This section documents all oral health services provided during the visit, including procedure codes, types of dental services, treatment dates, and the total costs associated with each procedure.
Common dental procedures covered under Aviva insurance policies include routine scaling and polishing, oral examinations, tooth extractions, composite fillings, crowns, and other approved dental services. Each procedure is listed separately with a corresponding code to help Aviva process your claim accurately. The dentist must review and sign this section to certify that all treatment information is correct and complete.
To submit your Aviva Ltd dental claim, attach the original treatment receipt from your dental provider along with the fully completed claim form. The receipt must show the dental services performed, the date of each treatment, and the total amount paid. Submit the completed form and receipt together to Aviva Ltd for review. Once the claim is approved, Aviva Ltd credits the reimbursement directly to the bank account provided in Section I, along with a payment advice note for your records.
For related dental and reimbursement forms, see the ADA Dental Claim Form, Guardian Dental Claim Form, or the Reimbursement Claim Form.
| Question | Answer |
|---|---|
| Form Name | AVIVA LTD Dental Claim Form |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 100 |
| Avg. time to fill out | 20 min 34 sec |
| Other names | aviva claim form pdf, aviva defer claim form, singapore aviva form online, aviva claim form |