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Delayed Departure

PERSONAL DETAILS
TRIP DETAILS
CLAIM DETAILS
SUPPORTING DOCUMENTS
SIGNATURE

PERSONAL DETAILS

*required

Travel Insurance Policy Number^*

Surname^*

E-mail Address^*

Mobile Number^*

Saudi ID Number^*

TRIP DETAILS

*required

Country of Destination^*

Trip Purchase Date^*

Insurance Policy purchase date^*

Type of Transport^*

CLAIM DETAILS

*required

Scheduled departure date^*

Scheduled departure time^*

Actual departure date^*

Actual departure time ^*

Total delayed hours ^*

Expenses^*

Paid
Not Paid

Add More Expenses

Reasons given by the transport provider for the cause of the delay

SUPPORTING DOCUMENTS

Recommended maximum file size to be less than 10MG

If nothing is attached, documents will be requested at a later date

*required

Passport Copy

Upload a file

Copy of the Ticket

Upload a file

Absher printout^*

Upload a file

SIGNATURE

*required

Claimant Name^*

Date of The Claim Opening^*

I have read and accepted the personal data collection consent

Tawuniya & its agents share information to prevent fraud & for underwriting purposes. This document, information supplied when taking out the Policy & relevant facts form the basis of your claim & may be shared or used for audit purposes. I/We understand that Tawuniya may seek information from other organizations to check that the information provided is truthful. I/We declare that to the best of my/our knowledge & belief that all the information I/we have given is correct. In the event of a third party being liable for the loss/damage all rights in this matter are subrogated to Tawuniya on settlement of the claim.

Delayed Departure

PERSONAL DETAILS

TRIP DETAILS

CLAIM DETAILS

SUPPORTING DOCUMENTS

SIGNATURE

your claim has been successfully submitted