Download a claim form

In order to support our policyholders during the current Coronavirus situation, we will be accepting scanned copies or good quality pictures of receipts with a completed claims form (which can be downloaded below) and submitted to Alternatively, return the form to the following address: HSF health plan, 5 Westgate Business Park, Kilrush Road, Ennis, Co.Clare

You may need to install Adobe Reader in order to fill in your form. This is a free software. Download from here Adobe Reader download
Please open the forms using any of the following browsers:

Internet Explorer

If you are using the Firefox browser, you will need to download the form first before completing, See image below.

Click on download button



1. Download the relevant editable claim form.
2. Fill in the details of your claim on the form.
3. Save the form.
4. Scan any receipts either with a scanner or use your mobile phone to take a good quality picture of the receipts.
5. Email Claims@hsf.iewith a short message attaching any scanned or photographed receipts and the saved form.

Claim Forms

Irish Distillers Claim Form Download

Family Scheme Claim Form Download

The ONE Scheme Direct Claim Form Download

Personal Accident claim forms are available upon request. Please contact us at, you can call us on 1890 473 473 where a member of our claims team will be happy to assist with your query.


Have you visited your MyPolicy page yet ? Through MyPolicy you can check your benefit balances, download a claim form, check your scheme details and access information on your HSF Assist® service .