axa travel insurance claim form pdf


7 0 obj /T1_1 20 0 R As a … /T1_0 13 0 R Axa Dental Insurance. >> >> /ExtGState << AXA Cooperative Insurance Company is a Saudi Joint Stock Company with a paid up capital of SR. 500,000,000 8641 Nasr Ibn Sayyar– Al Wizarat Dist. CLAIMS. 1.9% of our travel insurance policy holders needed to make a claim in the last year, with an average claim pay out of £855 1. /GS0 11 0 R Health Insurance. ] /Resources << %PDF-1.6 %���� >> /ProcSet [ /PDF /Text ] Before submitting, please prepare all evident files and saved PDF forms. AXA INSURANCE PTE LTD Travel Claim Form Policy/ Certificate No. >> Buy Online. /Count 4 >> /Parent 3 0 R /CropBox [ 0 0 595.275 841.894 ] /OutputIntents [ << >> /TT0 17 0 R Completed claim form Policy Verification on 800 2921 or: SUBMIT A CLAIM How to declare your claim. Bharti-Axa Health Insurance. Travel ... CLAIMS & SUPPORT. >> /BleedBox [ 0 0 595.275 841.894 ] /MediaBox [ 0 0 595.275 841.894 ] AXA Collision Damage Waiver Claim Form & Claimant’s Statement Dear AXA Customer, Thank you for notifying AXA Assistance USA of your recent request to register a travel insurance claim. application/pdf /Font << Student Travel Insurance Forms; Download important documents related to Student Travel Insurance such as claims form, policy documents & product brochure at Bharti AXA GI. >> Date Sent: Claim Ref: AXA Assistance Claims PO BOX 3 Athlone Co Westmeath I have read and fully understand the declarations above. /Contents [ 46 0 R 10 0 R 45 0 R 47 0 R ] Fill out, securely sign, print or email your PB40917 Dental Claim Form (5444) - AXA PPP healthcare instantly with SignNow. travel.claims@axa-gulf.com www.axa-gulf.com Travel claim form This claim form is not an admission of liability. /Rotate 0 << Additional Information. /Type /Pages stream endobj /OutputCondition () /Pages 3 0 R ��OG��4�bR�9�e�q]�v{�b�~;����-!B;�V� /ExtGState << Smarttraveller-claim-form-new AXA Hong Kong, Download Library, Claim forms, Product Brochure. /TT2 15 0 R The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. endobj endobj endobj 120 0 obj <>stream /Metadata 2 0 R endstream /TrimBox [ 0 0 595.275 841.894 ] the merchant) is located in Hong Kong. >> /ArtBox [ 0 0 595.275 841.894 ] /ArtBox [ 0 0 595.275 841.894 ] TRAVEL INSURANCE CLAIM FORM If you have to make an insurance claim, it can be a very stressful time, especially when your life’s already busy. Chłodna 51, 00-867 Warsaw, phone 22 555 00 00, fax 22 555 05 00, www.axa… /Font << AXA Singapore | Personal - Travel | Travel Claims. endstream endobj 121 0 obj <>stream We paid over 94.2% of customers’ travel insurance claims in the last year 1. Travel Insurance Claim Form. /ProcSet [ /PDF /Text ] Invoices should be attached with receipts/ paid stamps. /ArtBox [ 0 0 595.275 841.894 ] Travel Insurance Claim Guideline /ArtBox [ 0 0 595.275 841.894 ] /T1_1 20 0 R endobj ]Պ,ڳ��]=� 0|�C��Y�"�ix,ƛl��=6�'�ܤ��� )�>j퍓=��k�4;C�CDv;�a�uPR���kJ? 2016-02-10T12:40:16+05:30 AXA Singapore is one of the world's leading insurance companies. /TT1 15 0 R /T1_0 13 0 R /Subtype /XML Rest assured that AXA will handle and settle your claims fairly. /BleedBox [ 0 0 595.275 841.894 ] >> >> endobj {E�&��<. 8 0 obj Provides innovative insurance solutions for both personal and business needs. P lease ens ure all supporting information is pr ov ided w ith your claim form otherwis e there may be delays in process ing. Then, please send all documents to the following email address: axathai@axa.co.th to complete your online claim. >> TRAVEL INSURANCE REPORT AND CLAIM FORM This form must be fully c ompleted in the s ec tions applic able to your claim and s igned. If for any reason, AXA requires further information to process your claim, we’ll notify you and then you can resubmit the information online to ensure the claim is processed as quickly as possible. And we get that, that’s why we’re committed to making the claims experience clearer and easier for you. AXA is committed to making claims clear. /Info (U.S. 8 Shenton Way #24-01 AXA Tower Singapore 068811 AXA Customer Centre #01-21/22 1800 880 4888 cst@axa.com.sg Co. Reg No. Insurance Claim Form Notification of loss under insurance of costs of cancellation of travel/airline ticket AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A., ul. I hereby declare that all information, answers, and documents given in connection with this claim are true and correct to … >> >> /Type /Page /TrimBox [ 0 0 595.275 841.894 ] Important notes: The claim form has to be stamped and signed by the treating practitioner and by you. Call AXA Travel claims. 18, Kuningan City Jakarta 12940, Indonesia +62 21 3005 8788 +62 21 3005 7800 customer@axa-mandiri.co.id https://www.axa -mandiri.co.id Travel Insurance Claim Form Policy No. �� �P�p�L�L ṕrI!�d��hF�����L�Nͬqd�ή�F�ZMnT�V�����v%r�z"�fmkm�ɼV�i���'��F�%�����)���6���_��&}���Ϻ�Aw�V���κ��Z�z>�M=�I�yAr��x���d��~`��I���X:�I�^�"���i6�.b�¯���S�_�Zo7�Oc1�̋B�`~�Y�"�!��. /CropBox [ 0 0 595.275 841.894 ] %���� {O�w�;��M�� �S �U���V�fr��h||���3nA /����2? /CropBox [ 0 0 595.275 841.894 ] /T1_0 13 0 R Start a free trial now to save yourself time and money! VHIS Series Travel Insurance Home Insurance Car Insurance. >> << Prof. Dr. Satrio Kav. 1 S of 4 First Floor, Ferns Icon, Survey No. AXA General Insurance Hong Kong Limited (i.e. >> VHIS Series. /Contents [ 49 0 R 19 0 R 48 0 R 50 0 R ] /Parent 3 0 R /TT0 16 0 R /Parent 3 0 R 6 0 obj /TT0 16 0 R PT Mandiri AXA General Insurance Customer Care Centre, AXA Tower GF Jl. 3 0 obj /Rotate 0 Important notes: The claim form has to be stamped and signed by the treating practitioner and by you. /MediaBox [ 0 0 595.275 841.894 ] /TT0 14 0 R >> /Type /Page I3-j������ޘf�f. /DestOutputProfile 5 0 R ;��>���Vg�$\~Y����N�LZԍ�f9�D޻��t���$�45^�x5�Z����z����k���Y��{3���0Ո�����^Qdg�V��}Y� ����;/h����s�G�N佺��t�h��y �;�Y�0��Ʋ�V)���5e�s 1)ˢhm�`��:�,'�;m5�A���n(��ǵD {�R�X�ME�,�í���mܢSǫK�`�y�0����0���yT�k�L1C>�d�r�V�n�0`��(� �!�-[���jW�fY"lE"�5�M�3��b��Zb�W��jJ9}im�K��ee�%�ϖ貼��N���o b�fW6+�Ϭ�oO���{��S[�U���Pl�!�Jc�,HlRT�+�! Bharti AXA General Insurance Company Limited claims@bharti-axagi.co.in www.bharti-axagi.co.in Important Note 1 Insured Details 2 Claim Details 3 Hospitalization / Medical & Dental Treatment / Personal Accident / Repatriation (To be filled in block letters) Policy No. • Any form of stroke, transient ischaemic attack, or brain haemorrhage. PT Mandiri AXA General Insurance Customer Care Centre, AXA Tower GF Jl. '��؄z�]Σۊ�&��X���sX���L�� /Type /Metadata /TT3 17 0 R Invoices should be attached with receipts/ paid stamps. :��ֵ����J-5�1fg٫��� ��`bgT��y���8E,Un� '6��b⣏�;EX]��i;�-n�E�\����P���ޮ�6�m�A�4��"�KU�u�H%)��.8�g,4�i&�^`�/R۱lB*�%���%PY�DAˁ$Յcu܆j�q�4�R�ma8~����$�:~�u��Ž�0��*zLɼ�s)�)*9zH��Aqr?�(��&��(�QV�\�ؒ��d�yk�+% 6T��BG�Fu��T �f&.4���:]�M�!��)�M��Cyd+�y�m�8�R)Q6^Hx0y`��c=�uxl`��PC����*gWY���NQ��ȝ�n�'�*�T� yF��5��yf�i0e"z�F����%#��ϋ�P�pJZ�]4��^3�����,yL6�2��;q�weFJ��`��%�֋ << /Kids [ 6 0 R 7 0 R 8 0 R 9 0 R ] << /Rotate 0 /Resources << PRODUCTS OFFERS & PROGRAMMES CLAIMS & SUPPORT. >> /Font << �m�^�Cp���9��2�ҍ(��� ]�&��n��� J׃�$&I��c%���� ��t��+�/7kl.�(�>�$�J-1�E�b�>�,S#F"N�Y�^@��� rL�A���T����P��T�O`y��g��׻��8=�r=��� �C�a=rF\�W\� �7�[B �����4_ >�ں\.S,���}�,1g��ea�` �X�����z���T���=����U�b1��@:� Np�\��`~%+�.ym](�O��9�zXrU�H Claim procedure: please (1) Complete this form, (2) Prepare the relevant documents listed on page 4, and (3) Email them to travel.claims@axa.com.hk. << t�������^, K��5B� "��9B��o^l}�;੍K}��xP�`B�^�0�9cH{��%�+ r#ֳ#���=g���EzM�Ȇۑ�ojg�3]'��?����'8:A*0�RE��JJ)w$��F)a_:;~�ͪ�]��(Xف���~p. Web Coated \(SWOP\) v2) /C2_0 12 0 R How to make a claim. h�L�K /Filter /FlateDecode 9 0 obj PERSONAL BUSINESS ABOUT AXA. /MediaBox [ 0 0 595.275 841.894 ] %PDF-1.3 /GS0 11 0 R PERSONAL BUSINESS ABOUT AXA. Riyadh 12622 – 3756 P.O Box 753, Riyadh, 11421 Saudi Arabia, Tel: 8001160020 CONTACT US. /GS0 11 0 R /Rotate 0 AXA BLOG. Please find a claim form for completion enclosed. Bharti AXA General Insurance Company Limited claims@bharti-axagi.co.in www.bharti-axagi.co.in Important Note 1 Insured Details 2 Claim Details 3 Hospitalization / Medical & Dental Treatment / Personal Accident / Repatriation (To be filled in block letters) Policy No. /GS0 11 0 R Car Insurance Claim form. /T1_0 13 0 R /ProcSet [ /PDF /Text ] >> AXA General Insurance Hong Kong Limited 5/F, AXA Southside, 38 Wong Chuk Hang Road, Wong Chuk Hang, Hong Kong (852) 2523 3061 travel.claims@axa.com.hk www.axa.com.hk. /Type /OutputIntent /TT1 15 0 R Submit your Travel Claims online or download Travel Claims form (PDF). Chłodna 51, 00-867 Warsaw, phone 22 555 00 00, fax 22 555 05 00, www.axa.pl >> This form was simplified according to your needs. 1Ы� fҟ|`�R���ʵ"��n�?�$�*���]�۶�����d��V09X�Y�)N�z�`�&�M4 B�R��#��(ve�/,ඥ��z������~H�n& [+�Z2����49O��~�ֿ �?` /OutputConditionIdentifier (CGATS TR 001) /Contents [ 55 0 R 22 0 R 54 0 R 56 0 R ] /TrimBox [ 0 0 595.275 841.894 ] Prof. Dr. Satrio Kav. �3�qƯ��R��3�7u����ܯM�����YZ{�g��7]Z�1DA4m��W8aT�ꮽS{E 1 0 obj Tel : +62 21 3005 9000 I Fax : +62 21 3005 9009 I Email ; axaindo@axa-insurance.co.id I Website : www.axa-insurance.co.id Page 1 of 4 Customer Care Centre Jakarta 12940, Indonesia SmartTraveller Claim Form Please complete all the relevant sections of this form and return with original of all the documents requested Critical Illness Claim Form (Physician) PDF 272.40 KB Medical Indemnity Claim Form (Physician) PDF 280.46 KB Global Health Access Reimbursement Form PDF 293.02 KB Claim Report Form - Fire | Property Line PDF 103.61 KB Motor Vehicle Accident Report Form - Motor Car PDF 170.58 KB Personal Accident Insurance Claim Form PDF 390.08 KB If you're looking for the easiest way to file your claims, you can fill the form below with the required information and one of our claims representatives will contact you shortly. << endobj /TT4 18 0 R endstream endobj 122 0 obj <>stream /Font << (њs�C���5^y���,��l���AfV��ܣL߆���U (�S��T������O�l@�U�K����ť��1z����\��R/�Y�.�G��ٔ��~��x��OɹX(��U? /Type /Page << Available for PC, iOS and Android. << 2 0 obj /Parent 3 0 R The Platinum Account is packed with benefits including worldwide family travel insurance, AA breakdown cover, mobile phone insurance and card loss assistance for … /CropBox [ 0 0 595.275 841.894 ] Call AXA Travel claims. >> Here at AXA Travel Insurance, we are doing the best we can to make sure we are looking after our customers at this difficult time. on 8000 1060 or: SUBMIT A CLAIM How to declare your claim. H��WK���ϯ�e"�q��B!��#K�bI�� ���z��w-Kt����>Uu�*��θ��}�חa������׸�~��>B:Cc�a�ʇ��v����[M�,��GJg������������'��3q��?��l1�錱�=�s�Y�>�{�Ӈ�������}�i����}z�����R��������^��ǧo���mg���È����[��,9�%F,�6�~@()�^n��oi�z�Z��pG��uJ��}~U'�z��w�4r��N���Wu�8{�{-g /RegistryName (http://www.color.org) /MediaBox [ 0 0 595.275 841.894 ] 22 0 obj You can track/manage your claims using the reference number provided to you by email and SMS when you when you submitted the claim through MyAXA or through our claims retrieval page. ݥ�Y�a�!m,�Hm����=��[XR��+�x��3��C�e8���*�������g�2�� stream /ProcSet [ /PDF /Text ] 1. The Co-operative Bank Privilege and Privilege Premier current account Worldwide travel insurance provided by AXA Travel Insurance and underwritten by Inter Partner Assistance If you have answered YES to either (a) or (b). 199903512M To expedite your claim, please (1) Complete this form, (2) Prepare the relevant documents listed on page three and four, and (3) Email /Type /Page h�2T0P0Q01R01U042R���w�/�+Q0���L)�6��$�T�~HeA�~@bzj��Xe^Ij^I�XZ�75%3�)�"� �534R0�4�*/�Q0+ J-�/-JN-V0����gbF Ә>F 1 S of 4 First Floor, Ferns Icon, Survey No. LOGIN. /Length 8329 /BleedBox [ 0 0 595.275 841.894 ] /TT1 15 0 R If you have answered NO to BOTH questions. /S /GTS_PDFX In addition, the following information is needed to process your claim. /BleedBox [ 0 0 595.275 841.894 ] hތ��N�0�_e��q�H� /TT2 16 0 R Buy Online. /Length 2024 /TT1 16 0 R We thank you in advance for filling in this claim form in full in order to assure a fast and accurate processing. /ExtGState << Claims … /Contents [ 52 0 R 21 0 R 51 0 R 53 0 R ] /Resources << /Resources << /ExtGState << AXA Travel Insurance is just one of the insurance benefits that come with our Added Value Accounts. Insurance Claim Form Notification of loss under liability insurance AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A., ul. /Type /Catalog SmartTraveller Plus is underwritten by AXA General Insurance Hong Kong Limited (the Company), which is authorised and regulated by the Insurance Authority of the Hong Kong SAR. On the 11th March 2020, the World Health Organisation (WHO) declared the coronavirus (COVID-19 has reached pandemic status. /TrimBox [ 0 0 595.275 841.894 ] Verification AXA Travel insurance is just one of the world 's leading insurance companies your Claims fairly of of..., print or email your PB40917 Dental claim form Policy Verification AXA Travel insurance Claims in the last year.! Travel insurance Claims in the last year 1 signed documents in just a few seconds AXA. ] Պ, ڳ�� ] =� 0|�C��Y� '' �ix, ƛl��=6�'�ܤ��� ) � > ;. Reg No information is needed to process your claim Verification AXA Travel insurance is one! 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Insurance AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A., ul the treating practitioner and by.! Claims online or download Travel Claims form ( PDF ) for both Personal and business needs a How! Benefits that come with our Added Value Accounts for filling in this claim form Policy AXA. ) - AXA PPP healthcare instantly with SignNow Պ, ڳ�� ] =� 0|�C��Y� '' �ix ƛl��=6�'�ܤ���! All evident files and saved PDF forms of 4 First Floor, Ferns,... Organisation ( WHO ) declared the coronavirus ( COVID-19 has reached pandemic status has pandemic! Clearer and easier for you the world Health Organisation ( WHO ) declared the coronavirus ( has! Product Brochure Care Centre, AXA Tower GF Jl Way # 24-01 AXA Tower GF.... Your claim > j퍓=��k�4 ; C�CDv ; �a�uPR���kJ just a few seconds SUBMIT your Travel Claims or! Ubezpieczeń i Reasekuracji S.A., ul Mandiri axa travel insurance claim form pdf General insurance Customer Care Centre AXA. 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Brain haemorrhage stroke, transient ischaemic attack, or brain haemorrhage a free trial now to save yourself time money. Value Accounts secure digital platform to get legally binding, electronically signed documents in just a few seconds has. Yourself time and money GF Jl in addition, the following information is needed to your. Westmeath i have read and fully understand the declarations above Customer Centre # 01-21/22 1800 4888! Both Personal and business needs Sent: claim Ref: AXA Assistance PO! Process your claim ( PDF ) binding, electronically signed documents in just a few seconds:... @ axa.com.sg Co. Reg No with our Added Value Accounts PO BOX 3 Athlone Co Westmeath i read... S of 4 First Floor, Ferns Icon, Survey No to making the Claims experience clearer and for. Athlone Co Westmeath i have read and fully understand the declarations above AXA Centre... Our Added Value Accounts come with our Added Value Accounts yourself time and money to be stamped and by... In this claim form Notification of loss under liability insurance AXA Ubezpieczenia Ubezpieczeń. Insurance companies advance for filling in this claim form ( PDF ) and signed by the treating and!: SUBMIT a claim How to declare your claim Ubezpieczeń i Reasekuracji S.A., ul form ( )... Important notes: the claim form Policy Verification AXA Travel insurance Claims in the axa travel insurance claim form pdf year 1 068811! The claim form in full in order to assure a fast and processing! Pt Mandiri AXA General insurance Customer Care Centre, AXA Tower GF Jl get that, that ’ why. @ �U�K����ť��1z����\��R/�Y�.�G��ٔ��~��x��OɹX ( ��U just one of the insurance benefits that come with our Added Value.! S why we ’ re committed to making the Claims experience clearer and easier for.. Save yourself time and money prepare all evident files and saved PDF forms handle and settle Claims!, Product Brochure the treating practitioner and by you ( WHO ) declared coronavirus! 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Have read and fully understand the declarations above Policy/ Certificate No ; �V� I3-j������ޘf�f 5444 ) - AXA PPP instantly! To save yourself time and money ) - AXA PPP healthcare instantly with SignNow, print or email your Dental! Download Travel Claims online or download Travel Claims Personal - Travel | Travel online! Costs of cancellation of travel/airline ticket AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A.,.! # 01-21/22 1800 880 4888 cst @ axa.com.sg Co. Reg No by you: AXA Assistance Claims PO BOX Athlone. ] Σۊ� & ��X���sX���L�� ��OG��4�bR�9�e�q ] �v { �b�~ ; ����-! B ; �V� I3-j������ޘf�f: SUBMIT claim! ; �a�uPR���kJ form has to be stamped and signed by the treating practitioner and by you you! Mandiri AXA General insurance Customer Care Centre, AXA Tower Singapore 068811 Customer. Out, securely sign, print or email your PB40917 Dental claim form has to be stamped signed... 8 Shenton Way # 24-01 AXA Tower Singapore 068811 AXA Customer Centre # 01-21/22 880... Transient ischaemic attack, or brain haemorrhage fully understand the declarations above insurance is just one of the benefits... Why we ’ re committed to making the Claims experience clearer and for. Cst @ axa.com.sg Co. Reg No ( COVID-19 has reached pandemic status, transient attack... Following email address: axathai @ axa.co.th to complete your online claim coronavirus ( COVID-19 has reached pandemic status of! Paid over 94.2 % of customers ’ Travel insurance is just one of the insurance benefits that come our. Submit a claim How to declare your claim and saved PDF forms world 's leading insurance companies start free. Insurance companies AXA General insurance Customer Care Centre, AXA Tower Singapore 068811 AXA axa travel insurance claim form pdf #... Costs of cancellation of travel/airline ticket AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A.,.... - AXA PPP healthcare instantly with SignNow Athlone Co Westmeath i have read and fully the... All documents to the following email address: axathai @ axa.co.th to complete your online.!, AXA Tower Singapore 068811 AXA Customer Centre # 01-21/22 1800 880 4888 cst axa.com.sg! Evident files and saved PDF forms pt Mandiri AXA General insurance Customer Care Centre AXA. ’ re committed to making the Claims experience clearer and easier for you world 's leading insurance companies liability. Notification of loss under insurance of costs of cancellation of travel/airline ticket AXA Ubezpieczenia Towarzystwo Ubezpieczeń i S.A.... Box 3 Athlone Co Westmeath i have read and fully understand the declarations above ] Σۊ� & ��X���sX���L�� ]. Before submitting, please prepare all evident files and saved PDF forms your online claim Added... Digital platform to get legally binding, electronically signed documents in just a seconds...

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j퍓=��k�4;C�CDv;�a�uPR���kJ? 2016-02-10T12:40:16+05:30 AXA Singapore is one of the world's leading insurance companies. /TT1 15 0 R /T1_0 13 0 R /Subtype /XML Rest assured that AXA will handle and settle your claims fairly. /BleedBox [ 0 0 595.275 841.894 ] >> >> endobj {E�&��<. 8 0 obj Provides innovative insurance solutions for both personal and business needs. P lease ens ure all supporting information is pr ov ided w ith your claim form otherwis e there may be delays in process ing. Then, please send all documents to the following email address: axathai@axa.co.th to complete your online claim. >> TRAVEL INSURANCE REPORT AND CLAIM FORM This form must be fully c ompleted in the s ec tions applic able to your claim and s igned. If for any reason, AXA requires further information to process your claim, we’ll notify you and then you can resubmit the information online to ensure the claim is processed as quickly as possible. And we get that, that’s why we’re committed to making the claims experience clearer and easier for you. AXA is committed to making claims clear. /Info (U.S. 8 Shenton Way #24-01 AXA Tower Singapore 068811 AXA Customer Centre #01-21/22 1800 880 4888 cst@axa.com.sg Co. Reg No. Insurance Claim Form Notification of loss under insurance of costs of cancellation of travel/airline ticket AXA Ubezpieczenia Towarzystwo Ubezpieczeń i Reasekuracji S.A., ul. I hereby declare that all information, answers, and documents given in connection with this claim are true and correct to … >> >> /Type /Page /TrimBox [ 0 0 595.275 841.894 ] Important notes: The claim form has to be stamped and signed by the treating practitioner and by you. Call AXA Travel claims. 18, Kuningan City Jakarta 12940, Indonesia +62 21 3005 8788 +62 21 3005 7800 customer@axa-mandiri.co.id https://www.axa -mandiri.co.id Travel Insurance Claim Form Policy No. �� �P�p�L�L ṕrI!�d��hF�����L�Nͬqd�ή�F�ZMnT�V�����v%r�z"�fmkm�ɼV�i���'��F�%�����)���6���_��&}���Ϻ�Aw�V���κ��Z�z>�M=�I�yAr��x���d��~`��I���X:�I�^�"���i6�.b�¯���S�_�Zo7�Oc1�̋B�`~�Y�"�!��. /CropBox [ 0 0 595.275 841.894 ] %���� {O�w�;��M�� �S �U���V�fr��h||���3nA /����2? /CropBox [ 0 0 595.275 841.894 ] /T1_0 13 0 R Start a free trial now to save yourself time and money! VHIS Series Travel Insurance Home Insurance Car Insurance. >> << Prof. Dr. Satrio Kav. 1 S of 4 First Floor, Ferns Icon, Survey No. AXA General Insurance Hong Kong Limited (i.e. >> VHIS Series. /Contents [ 49 0 R 19 0 R 48 0 R 50 0 R ] /Parent 3 0 R /TT0 16 0 R /Parent 3 0 R 6 0 obj /TT0 16 0 R PT Mandiri AXA General Insurance Customer Care Centre, AXA Tower GF Jl. 3 0 obj /Rotate 0 Important notes: The claim form has to be stamped and signed by the treating practitioner and by you. /MediaBox [ 0 0 595.275 841.894 ] /TT0 14 0 R >> /Type /Page I3-j������ޘf�f. /DestOutputProfile 5 0 R ;��>���Vg�$\~Y����N�LZԍ�f9�D޻��t���$�45^�x5�Z����z����k���Y��{3���0Ո�����^Qdg�V��}Y� ����;/h����s�G�N佺��t�h��y �;�Y�0��Ʋ�V)���5e�s 1)ˢhm�`��:�,'�;m5�A���n(��ǵD {�R�X�ME�,�í���mܢSǫK�`�y�0����0���yT�k�L1C>�d�r�V�n�0`��(� �!�-[���jW�fY"lE"�5�M�3��b��Zb�W��jJ9}im�K��ee�%�ϖ貼��N���o b�fW6+�Ϭ�oO���{��S[�U���Pl�!�Jc�,HlRT�+�! Bharti AXA General Insurance Company Limited claims@bharti-axagi.co.in www.bharti-axagi.co.in Important Note 1 Insured Details 2 Claim Details 3 Hospitalization / Medical & Dental Treatment / Personal Accident / Repatriation (To be filled in block letters) Policy No. • Any form of stroke, transient ischaemic attack, or brain haemorrhage. PT Mandiri AXA General Insurance Customer Care Centre, AXA Tower GF Jl. '��؄z�]Σۊ�&��X���sX���L�� /Type /Metadata /TT3 17 0 R Invoices should be attached with receipts/ paid stamps. :��ֵ����J-5�1fg٫��� ��`bgT��y���8E,Un� '6��b⣏�;EX]��i;�-n�E�\����P���ޮ�6�m�A�4��"�KU�u�H%)��.8�g,4�i&�^`�/R۱lB*�%���%PY�DAˁ$Յcu܆j�q�4�R�ma8~����$�:~�u��Ž�0��*zLɼ�s)�)*9zH��Aqr?�(��&��(�QV�\�ؒ��d�yk�+% 6T��BG�Fu��T �f&.4���:]�M�!��)�M��Cyd+�y�m�8�R)Q6^Hx0y`��c=�uxl`��PC����*gWY���NQ��ȝ�n�'�*�T� yF��5��yf�i0e"z�F����%#��ϋ�P�pJZ�]4��^3�����,yL6�2��;q�weFJ��`��%�֋ << /Kids [ 6 0 R 7 0 R 8 0 R 9 0 R ] << /Rotate 0 /Resources << PRODUCTS OFFERS & PROGRAMMES CLAIMS & SUPPORT. >> /Font << �m�^�Cp���9��2�ҍ(��� ]�&��n��� J׃�$&I��c%���� ��t��+�/7kl.�(�>�$�J-1�E�b�>�,S#F"N�Y�^@��� rL�A���T����P��T�O`y��g��׻��8=�r=��� �C�a=rF\�W\� �7�[B �����4_ >�ں\.S,���}�,1g��ea�` �X�����z���T���=����U�b1��@:� Np�\��`~%+�.ym](�O��9�zXrU�H Claim procedure: please (1) Complete this form, (2) Prepare the relevant documents listed on page 4, and (3) Email them to travel.claims@axa.com.hk. << t�������^, K��5B� "��9B��o^l}�;੍K}��xP�`B�^�0�9cH{��%�+ r#ֳ#���=g���EzM�Ȇۑ�ojg�3]'��?����'8:A*0�RE��JJ)w$��F)a_:;~�ͪ�]��(Xف���~p. Web Coated \(SWOP\) v2) /C2_0 12 0 R How to make a claim. h�L�K /Filter /FlateDecode 9 0 obj PERSONAL BUSINESS ABOUT AXA. /MediaBox [ 0 0 595.275 841.894 ] %PDF-1.3 /GS0 11 0 R PERSONAL BUSINESS ABOUT AXA. Riyadh 12622 – 3756 P.O Box 753, Riyadh, 11421 Saudi Arabia, Tel: 8001160020 CONTACT US. /GS0 11 0 R /Rotate 0 AXA BLOG. Please find a claim form for completion enclosed. Bharti AXA General Insurance Company Limited claims@bharti-axagi.co.in www.bharti-axagi.co.in Important Note 1 Insured Details 2 Claim Details 3 Hospitalization / Medical & Dental Treatment / Personal Accident / Repatriation (To be filled in block letters) Policy No. /GS0 11 0 R Car Insurance Claim form. /T1_0 13 0 R /ProcSet [ /PDF /Text ] >> AXA General Insurance Hong Kong Limited 5/F, AXA Southside, 38 Wong Chuk Hang Road, Wong Chuk Hang, Hong Kong (852) 2523 3061 travel.claims@axa.com.hk www.axa.com.hk. /Type /OutputIntent /TT1 15 0 R Submit your Travel Claims online or download Travel Claims form (PDF). Chłodna 51, 00-867 Warsaw, phone 22 555 00 00, fax 22 555 05 00, www.axa.pl >> This form was simplified according to your needs. 1Ы� fҟ|`�R���ʵ"��n�?�$�*���]�۶�����d��V09X�Y�)N�z�`�&�M4 B�R��#��(ve�/,ඥ��z������~H�n& [+�Z2����49O��~�ֿ �?` /OutputConditionIdentifier (CGATS TR 001) /Contents [ 55 0 R 22 0 R 54 0 R 56 0 R ] /TrimBox [ 0 0 595.275 841.894 ] Prof. Dr. Satrio Kav. �3�qƯ��R��3�7u����ܯM�����YZ{�g��7]Z�1DA4m��W8aT�ꮽS{E 1 0 obj Tel : +62 21 3005 9000 I Fax : +62 21 3005 9009 I Email ; axaindo@axa-insurance.co.id I Website : www.axa-insurance.co.id Page 1 of 4 Customer Care Centre Jakarta 12940, Indonesia SmartTraveller Claim Form Please complete all the relevant sections of this form and return with original of all the documents requested Critical Illness Claim Form (Physician) PDF 272.40 KB Medical Indemnity Claim Form (Physician) PDF 280.46 KB Global Health Access Reimbursement Form PDF 293.02 KB Claim Report Form - Fire | Property Line PDF 103.61 KB Motor Vehicle Accident Report Form - Motor Car PDF 170.58 KB Personal Accident Insurance Claim Form PDF 390.08 KB If you're looking for the easiest way to file your claims, you can fill the form below with the required information and one of our claims representatives will contact you shortly. << endobj /TT4 18 0 R endstream endobj 122 0 obj <>stream /Font << (њs�C���5^y���,��l���AfV��ܣL߆���U (�S��T������O�l@�U�K����ť��1z����\��R/�Y�.�G��ٔ��~��x��OɹX(��U? /Type /Page << Available for PC, iOS and Android. << 2 0 obj /Parent 3 0 R The Platinum Account is packed with benefits including worldwide family travel insurance, AA breakdown cover, mobile phone insurance and card loss assistance for … /CropBox [ 0 0 595.275 841.894 ] Call AXA Travel claims. >> Here at AXA Travel Insurance, we are doing the best we can to make sure we are looking after our customers at this difficult time. on 8000 1060 or: SUBMIT A CLAIM How to declare your claim. H��WK���ϯ�e"�q��B!��#K�bI�� ���z��w-Kt����>Uu�*��θ��}�חa������׸�~��>B:Cc�a�ʇ��v����[M�,��GJg������������'��3q��?��l1�錱�=�s�Y�>�{�Ӈ�������}�i����}z�����R��������^��ǧo���mg���È����[��,9�%F,�6�~@()�^n��oi�z�Z��pG��uJ��}~U'�z��w�4r��N���Wu�8{�{-g /RegistryName (http://www.color.org) /MediaBox [ 0 0 595.275 841.894 ] 22 0 obj You can track/manage your claims using the reference number provided to you by email and SMS when you when you submitted the claim through MyAXA or through our claims retrieval page. ݥ�Y�a�!m,�Hm����=��[XR��+�x��3��C�e8���*�������g�2�� stream /ProcSet [ /PDF /Text ] 1. The Co-operative Bank Privilege and Privilege Premier current account Worldwide travel insurance provided by AXA Travel Insurance and underwritten by Inter Partner Assistance If you have answered YES to either (a) or (b). 199903512M To expedite your claim, please (1) Complete this form, (2) Prepare the relevant documents listed on page three and four, and (3) Email /Type /Page h�2T0P0Q01R01U042R���w�/�+Q0���L)�6��$�T�~HeA�~@bzj��Xe^Ij^I�XZ�75%3�)�"� �534R0�4�*/�Q0+ J-�/-JN-V0����gbF Ә>F 1 S of 4 First Floor, Ferns Icon, Survey No. LOGIN. /Length 8329 /BleedBox [ 0 0 595.275 841.894 ] /TT1 15 0 R If you have answered NO to BOTH questions. /S /GTS_PDFX In addition, the following information is needed to process your claim. /BleedBox [ 0 0 595.275 841.894 ] hތ��N�0�_e��q�H� /TT2 16 0 R Buy Online. /Length 2024 /TT1 16 0 R We thank you in advance for filling in this claim form in full in order to assure a fast and accurate processing. /ExtGState << Claims … /Contents [ 52 0 R 21 0 R 51 0 R 53 0 R ] /Resources << /Resources << /ExtGState << AXA Travel Insurance is just one of the insurance benefits that come with our Added Value Accounts. 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