Travel claim

Claim application
for travel insurance

Report a claim | Travel insurance | If Insurance

Claim applicant and sufferers

Required

Only latin characters allowed

Required

Only latin characters allowed

Required

Required

Check the phone number

Required

Check the e-mail address

I do not have e-mail address
Sufferers

Required

Required

Sufferer

Required

Only latin characters allowed

Required

Only latin characters allowed

Required

Check the phone number

Check the phone number

Check the e-mail address

Name {{ model.submitter.name }}

Surname {{ model.submitter.surname }}

ID code {{ model.submitter.code }}

Phone number {{ model.submitter.phoneNumber }}

E-mail {{ model.submitter.email }}

Sufferers

You are the sufferer? Yes No

Other sufferers

Name {{ sufferer.name }}

Surname {{ sufferer.surname }}

ID code {{ sufferer.code }}

Phone number {{ sufferer.phoneNumber }}

E-mail {{ sufferer.email }}

Accident description

Required

Date not valid

Date can not be in the future

Check the date

Correct time format is: 12:15

Time can not be in the future

Description of the accident {{ model.accidentDescription != undefined ? model.accidentDescription.length : 0 }} / 1000

Required

Injury/illness/damages description {{ model.injuryDescription != undefined ? model.injuryDescription.length : 0 }} / 1000

Required

Location of the accident

Date and time of the accident {{model.accidentDate | hkDate }} {{model.accidentTime | hkTime }}

Description of the accident

{{ model.accidentDescription }}

Injury/illness/damages description

{{ model.injuryDescription }}

Location of the accident

Country {{ model.accidentLocation.country }}

{{ model.accidentLocation.address.formattedAddress }}

Location description

{{ model.accidentLocation.description }}

Compensation

Required

Check the number. Correct is: 100 or 100.20

I don´t know the exact amount

I request the compensation

Compensation will go to me

Required

Required

Required

Required

Required

Required

I do not know account number

Required

Required

Name {{ model.compensation.recipient.name }}

Surname {{ model.compensation.recipient.surname }}

ID code {{ model.compensation.recipient.code }}

Name {{ model.compensation.recipient.name }}

Company reg. code {{ model.compensation.recipient.code }}

Bank {{ model.compensation.bankName }}

Account number (IBAN) {{ model.compensation.bankAccountNumber }}

Amount of claim {{model.compensation.claimAmount | hkCurrency: 'False' }}

Amount of claim I don´t know the exact amount

Additional information

Additional information {{ fileUploadProperties.pendingFilesCount + fileUploadProperties.uploadedFilesCount }} / {{ fileUploadProperties.maxFilesCount }}
File count limit reached. Some files has not been uploaded.
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{{ file.size | hkFileSize }}
{{ file.name }}
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Drop files here or click to upload
{{file.name}}

Privacy notice

If Insurance collects and processes personal data submitted with the claim and through the claims handling process according to the Privacy policy among other things: 1. to handle the claim and decide on the insurance indemnity; 2. to request information about the claim event (incl information concerning the state of health) from state and local government and other persons; 3. to contact you.