Appeal

Beware of Fraudulent “COVID-19 Compensation Lottery Prize” scam.

Hint: To understand the exact meaning of capitalized words used below, please visit the Program definitions.

What and when to appeal?

If your Application has been rejected by the Program’s Administrator because the Application is not a Receivable Claim, then you have the right to appeal that decision within a certain time limit. In order to appeal a rejected Application, you must:

If your Application was accepted by the Program’s Administrator as a Receivable Claim, but you have been denied compensation under the Program, then you have the right to appeal that decision within a certain time limit. In order to appeal the denial of compensation in respect of a Receivable Claim, you must:

  • Complete, sign and date the Notice of Appeal of Denied Receivable Claim Form (Schedule 5); and
  • No later than 90 days after the date of the Administrator’s claim denial notification, submit the following to the Program’s Administrator:
    • The completed Notice of Appeal of Denied Receivable Claim; and
    • Any additional documents in support of the appeal.

Please note that all appeals forms must be completed and submitted in English, French or Spanish (only) in order to be considered; the Program’s Administrator will not consider any appeals forms submitted in any other languages. However, additional documents provided in support of an appeal of a denied Receivable Claim may be submitted in any language.

Make sure to use the right Appeal form

If your Application has been rejected because it is not a Receivable Claim, and you wish to appeal such rejection, please complete and submit Schedule 4: Notice of Appeal of Rejected Application. You may not submit any other/additional documents in support of an appeal to a rejected Application.

If your Application has been accepted as a Receivable Claim but you have been denied compensation, and you wish to appeal such denial, please complete and submit Schedule 5: Notice of Appeal of Denied Receivable Claim, together with any additional documents you may wish to submit in support of that appeal.

Submit your appeal

You can submit your appeal in three different ways:

  1. Appeal online. You can upload the appropriate appeals form (and, if applicable, any additional supporting documents) online, and then click “Submit”, using the boxes below.
  2. Appeal by email. Send the appropriate appeals form (and, if applicable, any additional supporting documents) as attachments to the following email address: covaxclaims@esis.com
  3. Appeal by regular mail. Send the appropriate appeals form (and, if applicable, any additional supporting documents) to the Program’s Regional Center that services the AMC Eligible Economy in which the Vaccine was administered to the Patient, or directly to the ESIS headquarters, at the addresses which you can find on the Contact page.

Please remember that your appeal form must be submitted to the Program’s Administrator no later than 90 days after the Administrator’s notification of rejected Application or denied Receivable Claims, as applicable.


Appeal online

Where can I find my Application number?

  1. If you submitted an Application Form online, then your Application number was displayed on the confirmation page after the online submission and was also sent to the Applicant’s email address, if any, as provided in the Application.
  2. If you submitted an Application Form via email or regular mail, then your Application number was sent by the Program’s Administrator to the Applicant’s email address, if any, or mailing address as provided in the Application.
  3. If you need help in obtaining your number, please contact the Program’s Administrator at covaxclaims@esis.com for assistance.
Applicant Name


NOTE: in the field below, you can only upload a certain number of files at a time. Once the maximum number of files you can upload at a time is reached, please return to this page to upload any additional files you may wish to submit. You can repeat this operation as many times as necessary.

You can upload a maximum of 3 files at a time in this field.

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