GLOVO - Maternity Paternity (Non-European)

Parental Urgent Expenses

New parent benefit per childbirth, adoption or still birth offered by Qover and Chubb
Please note the following before filing your claim
- This insurance only applies to registered Courier App users
- This insurance covers the urgent expenses that you have following: birth of a child, adoption of a child or stillbirth
- Urgent expenses include (but not limited to)
  - Any urgent expenses for medical treatment or services necessary linked to the birth, adoption or stillbirth
  - Childcare or childminding in approved educational establishments.
  - Welfare treatments such as miscarriage, postpartum, depression …
- When can you file the claim
  - For maternity: as from 15 weeks before the expected birth date
  - For paternity: as from from the birthdate
  - Adoption: as from the assignment of the chil
  - Stillbirth: as from the event date
- Please note that the insurance company will require original copy of the birth (or adoption) certificate or any other document
In order to be covered, you must have used the App for at least 30 hours during the last 6 months.
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Your personal information

Please provide us the following details
Name*

First NameLast Name
Date of birth*

DayMonthYear
Date
Email*
example@example.com
Phone Number*
Where do you live ?
Street*
Number*
BoxNumber*
Locality*
Postcode*
City*
Country*
claimant_address_country*
If your country is not listed in the above dropdown, you can not benefit (yet) from this insurance
brokerName
fromEmail
replyTo
example@example.com

Your ID or passport number
Please upload a picture of your ID or passport.*

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Does this Glovo account belong to you, or is it in the name of a third party that legally subcontracted you?*
glovoRiderType*
What is your bank account number?*
In case of eligible claim, we might need it for reimbursement. For Europe : IBAN format is requested
Please upload a proof that you own the above mentioned bank account. Please do not upload any credit card information.*

Proof can be : print screen of your bank app, a picture of your banking card, a written statement issued from the bank,... This proof must link bank account number with your name.
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Parent Expenses
Please select the event type
When did the event take place?*

DayMonthYear
Date
- For birth of a child, please provide the birthdate
- For adoption, please provide the assignement date of the child
- For stillbirth, please provide the date of the event

Evidences
Please upload any document proving the event you are claiming for*

Birth certificate (or family book, adoption certificate...)
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Please upload all receipts or bills for medical costs you paid*

receipts you received at the time of payment: hospital, care, medication.
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Please upload the maternity report*

.
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Remember: your claim will be assessed only upon receipt of your medical file. If you can't provide one of the above, leave a comment to explain:
I acknowledge that my claim will be assessed only upon receipt of my medical file.*

I understand.

Data Protection, Fraud Prevention and Detection & Medical information
In order to administer your claim, this information will be used by the claim adjuster and the insurer and their subcontractors. It may be held on computer and or in manual files for administration and risk assessment purposes.By returning this form, you consent to our processing of your sensitive personal data for the above purposes. Where you have provided information about another person, you confirm that they have appointed you to act for them, to consent to the processing of their personal data, including sensitive data, to the transfer of their information abroad and to receive on their behalf any data protection notices.*

I agree with the Privacy Terms
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Parental Urgent Expenses