HSBC Travel Scheme Claim Form

Claim Type

Travel Section*

Policy Holder Details

Policy Number

First Name*

Last Name*

ID Number*

Occupation*

Email Address*

Enter Email Confirm Email

Contact Phone Number*

Was there at the time of the occurrence, any other existing travel insurance policy, including policies issued through other Banks?*

Yes
No

Details of other travel insurance policy

Trip Booking Date*

Confirm that Flights and/or Accommodation paid by HSBC Credit Card (Advance/Premier)*

Yes
No

Accident Details

Date of Accident*

Time of Accident

:

Location of Accident*

Police/Warden's Report Number (if applicable)

Departure Date from Malta

Arrival Date to Malta

Countries Visited

Brief description of claim*

Injured Persons

Name	Nature of Injury	Actions

There are no Persons.

Photos of Damages & Documents

Drop files here or

Max. file size: 5 MB.

If for any reason, including size of documents (should not exceed 5MB in size), they cannot be uploaded, you can send them through email on info@mib.com.mt.

Required Documents:

Confirmation (payment, documentation or statement) of HSBC card payments related to the Trip
Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Damage Report (Property Irregularity Report) issued on arrival by airline representatives
Original Luggage Tags
Original Boarding Pass
Photos of Damaged Luggage

Required Documents:

Confirmation (payment, documentation or statement) of HSBC card payments related to the Trip
Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Damage Report (Property Irregularity Report) issued on arrival by airline representatives
Original Luggage Tags
Original Boarding Pass
Original Delivery Report (presented by airline representatives on baggage delivery) (if baggage is delayed)
Original receipts of emergency items bought until arrival of baggage
Photos of Damaged Luggage

Required Documents:

Confirmation (payment, documentation or statement) of HSBC card payments related to the Trip
Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Initial Report (Property Irregularity Report) (issued on arrival by airline representatives)
Original Follow up Report - declaring lost baggage (issued by airline representatives following 30 days)
Proof of Ownership of Missing Items (receipts, guarantees, booklets, manuals, boxes, chargers)
Original Luggage Tags of flight during which the delay occurred
Original Boarding Pass of flight during which the delay occurred

Required Documents:

Confirmation (payment, documentation or statement) of HSBC card payments related to the Trip
Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Travel Itinerary incl. tour programme, accommodation details, excursions
Invoices/Receipts for prepaid expenses, flights, accommodation, excursions
Medical Report stating nature of illness and reason for cancelling trip
Death Certificate (if reason for cancellation) stating cause of death
In the event of a cancellation, clients are to notify immediately travel agent/ticket issuing office, to apply for refund of taxes and surcharges from airline

Required Documents:

Confirmation (payment, documentation or statement) of HSBC card payments related to the Trip
Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Medical Report issued by doctor who examined you abroad
Original Receipts for Related Medical Expenses (namely doctor's fees and prescribed medication)

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Police Report or Security Report issued at the location of theft/loss
Original Loss Report (Property Irregularity Report) only if theft/loss occurred from baggage during a flight and discovered on arrival
Detailed List of Stolen/Missing Items if more than one item had been stolen/lost
Proof of Ownership of Missing Items (receipts, guarantees, booklets, manuals, boxes, chargers)
Money Exchange Slip/Bank Withdrawal Statement (in the event of theft/loss of money)

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Printed Confirmation from Carrier or Authorities stating reason for the delay and number of hours in delay

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Original Medical Report issued by doctor who examined yo abroad
Hospital Discharge Letter showing date of admission into Hospital and date of discharge from Hospital

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Printed Confirmation from Transport Compay stating reason for the delay and numver of hours in delay
Dated Photographic Evidence by mobile or otherwise, showing any traffic jams, accidents, breakdown of vehicle etc.

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Printed Confirmation from Carrier or Authorities stating the number of hours in restraint from travel

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Printed Confirmation from Carrier or Authorities stating reason for cancellation and reshecule of service
Receipts of additional travel and accomodation expenses incurred during an overstay abroad
Receipts of prepaid expenses should you choose to cancel your holiday
In the event of cancellation, clients are to notify immedately travel agent / airline for refund of taxes and surcharges

Required Documents:

Copy of Passport/ID Card
Copy of Flight Tickets or Itinerary
Photocopy of Invoice / Receipt showing the Excess charged by rental company on repairs (if claim is for less than the policy limit)
Survey report showing a detailed breakdown of repairs
Hire vehicle contract showing excess payable
Dates Photographic Evidence by mobile or otherwise, showing damages, accidents, breakdown of vehicle etc.
Original Police Report or Security Report in the event of stolen / lost items, issued at location of theft / loss
Original Police Report in the event of a major traffic accident
Driving Licence

Terms Accept*

I have read and accept MIB's Client Terms of Business & Privacy Policy.*

I understand that by completing this form the data will be processed by MIB in line with GDPR and hereby consent that this data (including if needed sensitive data as defined in article 9 of GDPR) are used for the purposes of providing your insurance services.

I also understand that it is my responsibility to secure and hold the necessary consent from any employees, beneficiaries or other third parties direct or indirectly involved in the insurance proposal/arrangements and whose data will be processed by MIB and the providers of insurance and ancillary services.

HSBC Travel Scheme Claim Form

Claim Type

Policy Holder Details

Accident Details

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