Personal Baggage Delay & Loss of Travel Documents Form

PERSONAL DETAILS

*required

Travel Insurance Policy Number^*

Surname^*

Email Address^*

Mobile Number^*

*required

Advise the exact circumstances of how the loss/theft/damage/delay occured. Please provide the exact date and time.^*

Please confirm who the incident was reported to. Please explain if no report is available to support your claim.^*

Please confirm the precautions taken in order to secure your property.^*

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

Your claim is on a delayed possession case?

Date when your possessions were returned to you^*

Time when your possessions were returned to you^*

Your claim is on a loss of Travel Document case?

Date^*

Time^*

Expenses Incurred for Travel^*

Expenses Incurred for Accommodation^*

Passport Admin Cost^*

Total Claimed^*

Expiry Date of Passport^*

Further Details^*

Add More Expenses

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

*required

Airline Booking Invoice