Travel Insurance Claim Form

Submit your travel insurance claim documents

Please print and fill the Medical Reimbursement Claim Report by both you and the related hospital

Personal Information

Full Name *

Email Address *

Phone Number

Please upload the documents as either a photo or PDF file

Medical Reimbursement Claim Report *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Travel Visa *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Passport *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Entry & Exit stamp *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Initial Medical Report *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Travel Document *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

Hospital Invoice *

Upload Picture or PDF

Drag and drop files here

Max 10MB - Images or PDF only

The claim will be completely ignored if the documents were uploaded in a bad quality. Please make sure that you scan the required documents.

Before submitting, Please make sure that you have read and understand the terms and conditions

* All fields marked with asterisk are required