Application and notification forms (PDF)

Insurance application for recipients of grants and scholarships (4041e)

Instructions for filling in application form 4041e

Use this form to apply for insurance when you start working on a new grant or scholarship. Fill out the form separately for each grant or scholarship if there is more than one.

Group leader's notification (4002e)

This is the form for the leader of a working group. If the grant or scholarship has been given to a working group, the group leader uses this form to inform Mela of the names of the group members.

Application due to a change in circumstances (4046e)

This form is to be used when there has been a change in circumstances so that the insurance needs to be interrupted, for example in the case of maternity/paternity leave.

Claim form: Grant recipient's accident at work or during leisure time (7062e)

Claim form: Occupational disease (7061e)

Travel expense claim form (7064e)

Mela sickness allowance application (7066e)

With the claim forms you can apply for compensation and notify an accident or occupational disease sustained in the work covered by the MYEL insurance. If you also have the voluntary leisure-time MATA accident insurance, the form 7062e can be used to notify an accident taking place outside work.

The claim form (7062e or 7061e) must be submitted within 60 days of the accident or the date when the occupational disease was detected. Compensation for expenses (travel costs, medicines etc.) must be claimed within one year of the date they were incurred.

How to submit an application or a notification
Once you have completed, printed out and signed the form, you can mail it to Mela, or you can scan it and send it as an e-mail attachment.

If you wish to send the form as an e-mail attachment, please use Mela's secure e-mail service.

Processing of personal data in Mela
Insurance claims (MYEL) and the processing of personal data (GDPR 4518e, 4520e, 4522e, 4523e, 4526e, 4041e)

Accident claims (MATA) and the processing of personal data (GDPR 7060e, 7061e, 7062e)

Mela sickness allowance and the processing of personal data (GDPR 7066e)

Updated 01.11.2018