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670 Lafayette Ave, Brooklyn,
NY 11216

+1 800 966 4564
+1 800 9667 4558

GPA and WIBA

For GPA and WIBA claims, medical certificate shall be received after claimant has fully recovered.
GPA documents:

  • Claim form,
  • Medical report/certificate
  • Original medical receipts
  • Sick off sheet(where applicable)
  • 3 months payslips prior to the injury
  • Copy of claimant’s ID
  • Death certificate( if fatal)
    WIBA documents:
    • DOSH forms(1,4 & 7)
    • Claim form
    • Medical report
    • Original medical receipts
    • Sick off sheet(where applicable)
    • 3 months payslips prior to the injury
    • Death certificate (if fatal)
    • Detailed statement( Claimant & supervisor)
    • Police abstract(RTA or Assault)

  • • If certificate from attending doctor is not in line with continental scale, a second opinion shall be sought from a doctor on Britam’s panel of approved doctors.

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