Statement of loss under foreign travel insurance

Last name

Given name

Patronymic

E-mail

Telephone

Foreign Travel Insurance Contract No Example of contract No.: ALZ-0344001234567

Date of the insured event

Country of the insured event

Description of the insured event

File

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File ( )

I agree to the processing of personal information and understand the Personal Data Processing Policy

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We strive to provide our customers with the maximum remote services. If you have an insured event under a foreign travel insurance policy, you can claim it by filling in the form below. Please attach a completed and signed statement and documents
according to the list.

Please note that through this feedback form, you can claim an insured event only under a foreign travel insurance contract