1. Policy Information

2. Claimant Details


3. Travel & Loss Details

Type of Accident

Personal Accident / Medical Expenses / Hospital Allowance

Travel Delay/ Flight Delay / Flight Diversion

Flight Overbooking/ Travel Misconnection

Baggage Delay

Trip Cancellation / Curtailment / Bankruptcy of Travel Agent / Postponement

Loss/ Damage of Baggage/ Personal Effects/ Travel Document/ Money


Personal Liability

Did you pay the other party for his damage and / or injury?

Please let us have documentary proof.

Hijacking / Kidnapping / Extension of Cover/ Act of Terrorism

Additional Information

We will contact you on the necessary documents needed to process your claim

Total Amount Claimed (SGD)

4. Declaration, Authorization & Customer's Data Privacy Consent

[Declaration] I/We declare that the information given in this form is true and correct to the best of my knowledge and belief.

I/We understand that all information and supporting documents may be subject to review by Etiqa and Etiqa shall reserves all rights to recover any and all amounts if for any reason any claim is found to be fraudulent. Etiqa shall also reserve the right to pursue any actions at law or in equity that it deems appropriate in dealing with such fraudulent activity.

[Authorization] I/We hereby consent to and authorize the medical practitioner involved in the claimant’s care to discuss and disclose treatment details and discharge arrangements with and to Etiqa Insurance Pte Ltd. I/We agree that a copy of this consent shall have the validity of the original.

[Customer’s Data Privacy Consent] I/We further declared that the information written in this claim form or held by Etiqa Insurance Pte Ltd whether contained in my/our insurance application or otherwise obtained may be used and disclosed to your authorised staff, associated individuals and/or companies or any independent third parties (within or outside Singapore) who will provide claims administrative, advice and/or information or claims services in relation to my/our claim. I/We understand my/our data that may also be used for audit, business analysis and reinsurance purposes.

5. Documents Required for Claim Assessment

Below is a list of minimum documentation required to process your claim. Additional information may be required for further assessment.

Type of Loss/Accident

Documents Required (Please tick against the documents you have submitted)

(plus) as applicable below:

Basic for all type*

Accidental Death / Permanent Disablement

Medical Expenses / Hospitalisation

Trip Cancellation / Curtailment / Bankruptcy of Travel Agent / Postponement

Loss / Damage of Personal Effects / Travel Document / Money

Baggage Delay

Travel Delay / Flight Diversion

Flight Misconnection / Overbooked

Flight Postponement

Personal Liability

Special Benefits

6. Supporting Documents Upload

Upload Supporting Documents
Please note: Total file size should not exceed 10MB.
Please only upload files that end in types: .jpg, .png, .jpeg, .pdf
Please attach the relevant supporting documents with your claims submission to expedite claim processing.
Drop files here to upload

7. Final Step

Please review and ensure all details are accurate before you proceed.