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+380 44 287 88 70

Declare a claim

  1. In case if Insured needs medical help when travelling, he or his representative should immediately contact our 24h call-center by the telephone numbers, stated on the web-site as well as on the insurance policy and inform the following:

    1. Full name of the Insured, DOB.
    2. Name of the insurance company, policy number, term of validity.
    3. Description of the problem, circumstances, complaints and what kind of assistance is needed.
    4. Contact phone numbers, both cell phone and fixed line phone numbers.
    5. Exact location of the Insured: hotel name, address, room number.

    Being in the hospital, pleae advise hospital name, address and department.

    If you want to declare a claim, but due to some reasons you cannot reach us by phone, we ask you to complete the form provided on our web site and our operators will contact you. If you do not receive a call within 20 minutes, we ask you to find another way to contact us.

    If you have already been exami by a doctor and you have paid the expenses referred to the insurance case, please save all the documents necessary for claims handling and reimbursement of the expenses:

    • medical report with exact diagnosis, results of the examinations made, treatment principle.
    • paid invoice with the list of all rendered services, with specification of every service and exact date when it was rendered
    • prescriptions for medicine
    • documents which prove that you have paid for the medical or other services (receipts, checks)

    Please note that only pre-appointment call to our 24h call-center guarantees proper free of charge medical or other emergency assistance for the Insured.

    While traveling do not forget to take your travel first-aid box with the medicine you always use. This will save you from trouble and will save your precious time of vacation.

  2. Full Name of the Client who needs Medical Help*
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  3. Date of Birth*
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  4. Insurance company*
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  5. Policy*
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  6. Validity from*
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  7. Validity to*
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  8. Franchise
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  9. Currency*
  10. Insurance Program
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  11. Client location
  12. Country*
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  13. City*
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  14. Hotel
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  15. Room Number /Residential Address/ Hospital, Medical Institution Name, address, departments, phone numbers (if known)
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  16. Сontact phones*
  17. Local (with dialing code)*
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  18. Cell Phone (with dialing code) *
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  19. Client’s e-mail
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  20. Contact Person’s Phone Number/Tour Guide, Relative, Doctor
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  21. Complaints. Symptoms, what kind of assistance is needed.*
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