Claim form for reduced earning capacity and waiver of premium
Fill out the claim form electronically here. Be sure to set aside time to complete the claim. You must have an email address to complete the application.
You need to upload pdf files with the following information:
- copy of the notice of approval of claim for benefits from the municipality.
- copy of the latest payment specification from the municipality on the benefit that you or your employer receives.
If you are not in a course via the municipality (e.g. if you or your employer do not receive sickness benefits), you must instead have completed a medical certificate with your doctor. Contact us on phone +45 70 33 37 13 so we can help you with that. You can see more about the process and how we can help here.
You sign your application with your MitID.
Claim form for reduced earning capacity and waiver of premium
About the claim
You complete the claim via a secure connection on our partner Addo Sign's platform. Addo Sign has the same obligations as we have in relation to the processing of sensitive personal data. Read more about security at Addo Sign here.