العربية
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TRIP CURTAILMENT
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PERSONAL DETAILS
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TRIP DETAILS
description
CLAIM DETAILS
attach_file
SUPPORTING DOCUMENTS
create
SIGNATURE
PERSONAL DETAILS
*required
Travel Insurance Policy Number
*
Surname
*
E-mail Address
*
Mobile Number
*
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7370
Saudi ID Number
*
TRIP DETAILS
*required
Country of Destination
*
Select Country
Afghanistan
Albania
Aland Islands
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Saint Barthelemy
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Curaçao
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Guernsey
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Isle of Man
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jersey
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea(North Korea)
Korea(South Korea)
Kosovo
Kuwait
Kyrgyzstan
Lao PDR
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Sri Lanka
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russian
Rwanda
Saint Kitts and Nevis
Saint Martin (French part)
Sint Maarten (Dutch part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich
South Sudan
Spain
Saint Helena
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
US Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (U.S.)
Vatican City
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Trip Purchase Date
*
Insurance Policy purchase date
*
CLAIM DETAILS
*required
Date of Return
*
Date you should have returned
*
Number of Days Missed
*
Cause of curtailment
*
-- Select --
Policyholder tested positive to COVID-19
Travel companion tested positive to COVID-19
Policyholder being identified as a close contact by the health authorities and being unable to travel
Severe illness or death of a close family member
Type Reason
*
Total Amount Claimed
*
-- Select --
AED
AFN
ALL
AMD
AOA
ARS
AUD
AWG
AZN
BAM
BBD
BDT
BGN
BHD
BIF
BMD
BND
BOB
BRL
BSD
BTN
BWP
BYR
BZD
CAD
CDF
CHF
CLP
CNY
COP
CRC
CUP
CVE
CZK
DJF
DKK
DOP
DZD
EGP
ERN
ETB
EUR
FJD
FKP
GBP
GEL
GHS
GMD
GNF
GTQ
GYD
HKD
HNL
HRK
HTG
HUF
IDR
ILS
IMP
INR
IQD
IRR
ISK
JEP
JMD
JOD
JPY
KES
KGS
KHR
KMF
KPW
KRW
KWD
KYD
KZT
LAK
LBP
LKR
LRD
LSL
LTL
LVL
LYD
MAD
MDL
MGA
MKD
MMK
MNT
MOP
MRO
MUR
MVR
MWK
MXN
MYR
MZN
NAD
NGN
NIO
NOK
NPR
NZD
OMR
PAB
PEN
PGK
PHP
PKR
PLN
PRB
PYG
QAR
RON
RSD
RUB
RWF
SAR
SBD
SCR
SDG
SEK
SGD
SHP
SLL
SOS
SRD
SSP
STD
SVC
SYP
SZL
THB
TJS
TMT
TND
TOP
TRY
TTD
TWD
TZS
UAH
UGX
USD
UYU
UZS
VEF
VND
VUV
WST
XAF
XCD
XOF
XPF
YER
ZAR
ZMW
ZWL
Please select a currency
SUPPORTING DOCUMENTS
Recommended maximum file size to be less than 10MG
If nothing is attached, documents will be requested at a later date
*required
The files you have uploaded have exceeded the maximum amount (10 MB).
Passport Copy
Passport Copy
Upload a file
Copy of the Ticket
Copy of the Ticket
Upload a file
Absher printout
*
Absher printout
Upload a file
COVID19- Test Results (Policyholder/Travel companion)
COVID19- Test Results (Policyholder/Travel companion)
Upload a file
Health authorities’ instruction for travel restriction
Health authorities’ instruction for travel restriction
Upload a file
Medical Certificate of family member for serious illness
Medical Certificate of family member for serious illness
Upload a file
Death Certificate of family member
Death Certificate of family member
Upload a file
Proof of relationship with Travel companion/ family member
Proof of relationship with Travel companion/ family member
Upload a file
Proof of Early Return
Proof of Early Return
Upload a file
Proof of expenses lost
Proof of expenses lost
Upload a file
SIGNATURE
*required
Claimant Name
*
Date of The Claim Opening
*
I have read and accepted the
personal data collection consent
You should approve Privacy and Policy terms.
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.
You should approve the declaration statement.
your claim has been successfully submitted
our claim representatives will be in touch with you soon
Done
