Before you submit this form please show the statement below to anyone over 16 that
you wish to cover on this plan, or inform them of its contents.
To set up and manage your plan, we (AXA PPP healthcare Limited) will hold and use
information about you and any of your family members. This information may have
been supplied by you, those family members, healthcare providers or, if your plan
is part of a group scheme, the employer. Please only provide us with sensitive information
(such as health information) about family members aged over 16 if you have their
consent to do so. If you give us this information we’ll take this as confirmation
that you have that consent.
We use other companies to do some of our work for us and to run and improve our
computer systems. As well as communicating with your healthcare providers we provide
non sensitive information to your intermediary (if you use one) and, if your plan
is part of a group scheme, to the employer and the employer’s intermediary (if they
use one). We transfer information to countries outside the European Economic Area
(EEA) where the laws protecting personal information are not as strong as in the
EEA. We take steps to make sure that companies working for us give an appropriate
level of protection.
The lead member is the legal owner of the plan. We send most of our written communications
about the plan and about claims to the lead member. If any person over 18 that you
intend to cover under the plan doesn’t want us to do this that person should apply
for their own plan.
By clicking on "Continue" you confirm that:
any family members have agreed that the lead member can act for them to set up this
the lead member consents on behalf of those family members and themselves to AXA
PPP healthcare Limited using personal information in the ways described above.
We may pass information directly to third parties or by using shared databases.
These third parties will include other insurers and law enforcement agencies. This
is to prevent or investigate crime, including fraudulent or other improper claims.
In some circumstances we must give information about our suspicions of crime to
law enforcement agencies. We must let the relevant regulatory body know when we
have good reason to question a healthcare provider’s fitness to practice.