Index

Your Details

Your Name

Address

Country

Email Address

Confirm Email Address

Telephone

Type of Insurance

Valued inventory with all items in my move listed One LUMP SUM value for my entire move LUMP SUM value + HIGH value list. I’m not sure

Currency

Total Insured Value

Currency

Lump Sum Total

Currency

Lump Sum Total

High Value Total

Claim Total

Shipment Details

Shipment Certificate Number

Packing Date

Delivery Date

Moving Company

Did you sign the Delivery Receipt ?

Yes No

Did you note damaged and/or missing items on the Delivery Receipt ?
Under the policy terms and conditions, a clean delivery receipt is prima facie evidence of the shipment arriving in good order and condition.

Yes No

Please Explain Why

Cargo Location

Cargo Address

Claim Form

It’s now time to build your detailed claim, listing each item and its relevant claim amount. If you are not ready to submit these details, please simply indicate below the approximate amount of your overall claim and then click “submit”. This will register your claim immediately and allow you to come back later to complete the detailed claim form.

I have all the information to build my detailed claim

Damaged Lost Items

I wish to build my claim at a later stage

Below USD2,000 Between USD2,000 and USD10,000 Above USD10,000