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Insurance
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HSBC Home Loans Buildings Policy Claim Form
Policy Holder Details
Policy Number
First Name
*
Last Name
*
ID Number
*
Email Address
*
Enter Email
Confirm Email
Contact Phone Number
*
Accident Details
Date of Accident
*
Date Format: DD slash MM slash YYYY
Time of Accident
:
HH
MM
AM
PM
Location of Accident
*
Police/Warden's Report Number (if applicable)
Brief description of claim
*
Injured Persons
Name
Nature of Injury
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Photos of Damages & Documents
Drop files here or
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.
Insurance
Health Insurance
Home Insurance
Travel Insurance
Motor Insurance
Boat Insurance
Personal Accident Insurance
Life Insurance
Retirement Planning
Sports Medical Insurance
Get a Quote
Make a Claim
Insurance
Transit Insurance
Liability Insurance
Marine Insurance
Aviation Insurance
Property Insurance
Financial Risks Insurance
Professional Indemnity Insurance
Cyber Insurance and iGaming Exposures
Engineering Insurance
Employee Benefits
Construction Insurance
Motor Fleets & Tool of Trade
Risk Consultancy
Get a Quote
Make a Claim
Name
*
Address
Nature of Injury
*
Admitted to hospital?
Yes
No
Hospital name
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