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Travel Insurance Claims Registration

As your trusted insurance partner, we’ll make your claim process quick and easy.

1 Insured Details
2 Claim Details

Please fill the claims details for policy number .

Name of claimant

Date of birth

Passport number

Policy start date

Policy end date

Mobile number +91

Email ID

Overseas mobile number (Optional)

Proceed

Date of Incident occurred

Type of claim

Select

Relevant Category

Select

Relevant Category

Select

Date of admission Please enter date of admission

Date of discharge Please enter date of discharge

Summary Please enter summary

Name of hospital, if applicable Please enter name of hospital

Type of claim

Select

Please select

Name of overseas hospital Please enter name of overseas hospital

Address of overseas hospital Please enter address

Zipcode of overseas hospital Please enter zipcode of overseas hospital

Diagnosis/Illness Please enter diagnosis/illness

Date of admission Please enter date of admission

Date of discharge Please enter date of discharge

Treatment type

Select

Please select

Name of overseas hospital Please enter name of overseas hospital

Address of overseas hospital Please enter address

Zipcode of overseas hospital Please enter zipcode of overseas hospital

Diagnosis/Illness Please enter diagnosis/illness

Type of claim

Select

Please select

Name of overseas hospital Please enter name of overseas hospital

Address of overseas hospital Please enter address

Zipcode of overseas hospital Please enter name of overseas hospital

Diagnosis/Illness Please enter diagnosis/illness

Date of admission Please enter date of admission

Date of discharge Please enter date of discharge

Treatment type

Select

Please select

Type of claim

Select

Please select

Name of overseas hospital Please enter name of overseas hospital

Address of overseas hospital Please enter address

Zipcode of overseas hospital Please enter zipcode of overseas hospital

Diagnosis/Illness Please enter diagnosis/illness

Date of admission Please enter date of admission

Date of discharge Please enter date of discharge

Treatment type

Select

Please select

Date of admission Please enter date of admission

Date of discharge Please enter date of discharge

Summary Please enter summary

Name of hospital, if applicable Please enter name of hospital

Where did the
loss occur Please enter loss occur location

Estimated loss
amount(Rs) Please enter loss amount

Has the airlines been notified at the time of loss?

Select

Please select

Details of compensation received from airline Please enter details

Have you reported to the police?

Select

Please select

Summary Please enter summary

Details of injury/property damaged Please enter details

Did you receive a court order?

Select

Please select

Summary Please enter summary

Flight number Please enter flight number

Scheduled date of flight arrival Please enter scheduled date of flight arrival

Scheduled time of flight arrival

HH:MM

Please select

Country from Please enter country from

Country to Please enter country to

Actual date of flight arrival Please enter actual date of flight arrival

Actual time of flight arrival

HH:MM

Please select

No of hours delayed Please enter no of hours delayed

Reason for trip delay Please enter reason

Summary Please enter summary

Date of cancellation/curtailment Please enter date of cancellation

Country from Please enter country from

Country to Please enter country to

Reason for cancellation/curtailment Please enter reason

Date of cancellation/curtailment Please enter date of curtailment

Country from Please enter country from

Country to Please enter country to

Reason for cancellation/curtailment Please enter reason

Where did the delay occur Please enter delay occur location

Scheduled date of flight arrival Please enter scheduled date of flight arrival

Scheduled time of flight arrival

HH:MM

Please select

Date of baggage delivered Please enter date of baggage delivered

Time of baggage delivered

HH:MM

Please select

No of hours delayed Please enter no of hours delayed

Details of incident Please enter details

Have you reported to the police?

Select

Please select

Details of incident Please enter details

Have you reported to the police?

Select

Please select

Mobile number +91 Please enter mobile number

Flight number Please enter flight number

Scheduled date Please enter scheduled date

Scheduled time

HH:MM

Please select

Country from Please enter country from

Country to Please enter country to

Actual date Please enter actual date

Actual time

HH:MM

Please select

No of hours delayed Please enter no of hours delayed

Summary Please enter summary

Original flight number Please enter original flight number

Original flight date Please enter original flight date

Country from Please enter country from

Country to Please enter country to

Changed flight number Please enter changed flight number

Changed flight date Please enter date

Changed country from Please enter change country from

Changed country to Please enter change country to

Hotel registration start date Please enter hotel registration start date

Hotel registration end date Please enter hotel registration end date

Details about incident Please enter details

Proceed

Disclaimer

I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

Please enter valid quote reference ID

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