What do you fill out on the contact form? Go to the online contact form. Under ‘Which scheme is involved?’, choose ‘Health insurance and abroad’. Please enter the following details in the message field: your first name and surname (or those of the family’s contact person) your or the contact person’s telephone number your or the contact person’s email address your or the contact person’s postal address Under ‘Add attachment’, click the pink box with the arrow. Find the death certificate (.pdf or .jpg) on your computer and add the certificate. In the next block enter: the deceased person’s initials the deceased person’s surname NB Your own email address your own telephone number In the last block enter: Under ‘CAK reference’, the deceased person's ID insurance number. You will find this on all the letters we have sent to the client; Under ‘Date of birth’, the deceased person's date of birth.