Allianz Sri Lanka | Notify Property and Casualty Claim

PROPERTY AND CASUALTY CLAIM NOTIFICATION

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1. INSURED DETAILS

Name of the Policy Holder

Policy no

Telephone No

Home / Office

Mobile

Email Address

Error Invalid

Date & Time of Loss

Date

DD/MM/YYYY

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Error

Nature or cause of loss

Time am / pm

Address or Location where the event occurred

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I accept the data privacy guidelines

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DECLARATION

The claim will be formally registered once written intimation is received by the company
List of documents & forms will be provided considering policy status is in-force on the date of event
Allianz Insurance Lanka Ltd reserves the right to ask for more documents and information’s to consider the claim
Claim proceeds are payable as per terms and conditions in the policy document
Notifications of claim, submission of claim forms and/or claim documents to the Company shall not be construed as admission of liability by the company
By submitting this form, you accept above terms and conditions.

PROPERTY AND CASUALTY CLAIM NOTIFICATION

1. INSURED DETAILS

Telephone No

Date & Time of Loss

DECLARATION

How can we help you?

Need individual support or more information?

Notify Property and Casualty Claim

PROPERTY AND CASUALTY CLAIM NOTIFICATION

1. INSURED DETAILS

Telephone No

Date & Time of Loss

DECLARATION

How can we help you?

Need individual support or more information?

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