Please prepare the documents needed for your claim

Choose this form if, for reasons beyond your control, it was necessary to cancel or interrupt your trip.

Package travel participation agreement
Proof of payment for the package travel
Cancelled package travel agreement (including the settlement with the tour organiser/travel agency)
Declaration of cancellation or interruption of participation in the package travel, certified by the travel agency
Insurance policy

Document confirming the degree of kinship
Witness statements
Death certificate, death record and statistical death card, or another document specifying the cause of death
Other documents confirming the validity of the claim
Declaration consenting to the processing of personal data and obtaining medical records - if the insured event concerns a close person or fellow traveller other than the person reporting the claim
Medical records with diagnosis and date of treatment

Reporter details

Fill the form with random test data

Firstname

Lastname

E-mail address

Country code, e.g. 48

Mobile phone number

Date of birth

Sex

woman man I prefer not to give

Country

City

Street and house/flat number

Zip code

Is the claimant also the insured?

yes no

A claim can be made by an injured adult or his/her parent/legal guardian if the injured party is a minor.

Injured party details

Firstname (of the injured party)

Lastname (of the injured party)

Date of birth (of the injured party)