Travel Documents

PERSONAL DETAILS
Claim Details
Supporting documents
Signature

PERSONAL DETAILS

*required

Travel Insurance Policy Number^*

Surname^*

Email Address^*

Mobile Number^*

Claim Details

*required

Advise the exact circumstances of how the loss or theft occurred. Please specify the location of the incident as well as the list of documents lost or stolen.^*

Have you received refunds from any other sources? If so, please provide details.^*

Date of the Incident^*

Incurred Expenses^*

Number of Documents ^*

Further Details^*

Add More Expenses

Supporting documents (Max 10MB)

if nothing is attached, documents will be requested at a later date

Passport Copy

Upload a file

Copy of Original Travel Tickets

Upload a file

Incident Report (third party – police, hotel or airlines)

Upload a file

Receipt for Expenses

Upload a file

Signature

*required

Claimant Name^*

Date of Claim Opening^*

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