ERICON broker - aLC Health

On our aLC Health Download Page you currently have access to all relevant forms related to your Prima medical insurance plans in English and Russian. The files are in .pdf format (Acrobat Reader for free here) and can be downloaded by clicking either the thumbnail or title.

English Documentation

July 24, 2023

aLC Health - Prima plan application | version 03.2021ALC Health's application with no medical questions for their Prima Classic, Prima Premier and Prima Platinum plan, underwritten by XL Insurance Company SE. Language: English690 KB
aLC Health - English Prima Plan Guide | version 01.2022Offering 3 insurance plans - economic, mid-range and comprehensive - ALC Health's "Plan Guide" will help you make the right choice.2 MB
aLC Health - English Prima Plan Policy Wording | version 10.12.2021For policies that incepted/ renewed on, or after 1st January 2022.2 MB
aLC Health - English Prima Plan Policy Wording | version 23.11.2020For policies that incepted/ renewed on, or prior to 31st December 2021.767 KB
aLC Health - English Product Information Documents | version 01.2023ALC's product information sheets for their Prima Plans Classic, Premier and Platinum.1 MB
ALC Health - English Summary of Changes Overview | version 01.01.2022Constantly thriving to improve their benefits & terms, aLC Health frequently improve some of the benefits under their Prima plan range.730 KB
aLC Health - English health declaration formThis form is to be used when wanting to upgrade an existing plan or when to signing up for insurance, full medical underwriting is required. The form can be used for a total of 4 5 persons600 KB
ALC Health - Payment Terms & ConditionsALC Health's banking information for GBP, Euro and US Dollar wire-transfers. 227 KB
aLC Health - Catlin SEPA Direct Debit formYou would like ALC to debit your health insurance premiums from an EU bank account, then this is the form you are looking for.225 KB

Prima Plans - Claim Forms

aLC Health - English Claims Guide for 'XLCP' policiesaLC Health's 'step-by-step claim guide' for all policy numbers starting with 'XLCP'. Following the instructions will assure a swift and uncomplicated claims procedure with their claim-handler, Global Response.289 KB
aLC Health - English Claims Guide for 'CATP' policiesaLC Health's 'step-by-step claim guide' for all policy numbers starting with 'CATP'. Following the instructions will assure a swift and uncomplicated claims procedure with their claim-handler, Global Response.261 KB
aLC Health - English Medical CertificateUse aLC Health's medical certificate in order to help their claim-handler 'Global Response' to process your claim as quickly as possible.238 KB
aLC Health - English Medical Information Release formThis ALC Health form is to be completed when further information from the treating medical physician is required, thus the insured's authorisation is necessary to share data.245 KB
aLC Health - English Dental claim formaLC Health's 'dental claim form to assure a swift and uncomplicated filing of a claim with their claim-handler, Global Response.267 KB
ALC Health - Direct Invoice SettlementAs an ALC Health member you can receive treatment at many Helios hospitals/ clinics in Germany and other medical facilities in Spain or Portugal without the need to pay yourself.249 KB
aLC Health - English Out-patient claim formaLC Health's form to file an out-patient treatment claim.260 KB
aLC Health - English Hospital-Cash-Benefit claim formaLC Health's 'Hospital Cash Benefit claim form to use when certain inpatient benefits have not been made use of.255 KB
aLC Health - English Pregnancy claim formWith this ALC Health claim form you can file for their Childbirth and Pregnancy benefits.258 KB
aLC Health - English Well-being, Vaccinations and Optical claim formUse this aLC Health claim form to receive reimbursements for Well-being • Vaccinations or Optical treatment.258 KB

German Documents

Russian Documents

aLC Health - Russian Prima plan guide2 MB