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Form I-01 - Application for insurance benefit (individual clients)

Form G-01 - Application for insurance benefit (group clients)

Policy changes - Form for policy changes

Surrender - Form for policy surrender

Change - Form for Policyowner change

 

Who should apply and fill in the documents?
The insured person who suffered the injury or his/her trustee if the insured is under-age.  
 
What documents should be submitted to the company:

  • Application for Insurance benefit – Form I-01.
  • Copy of the personal identification document (ID card or passport). In case of injured child - a copy of birth certificate.
  • Documents that confirm the insured event – medical documents proving the injury, diagnosis, treatment, etc.
  • In case of broken bones, please submit an X-ray or indicate the medical facility where it was taken.  
  • If the insured event was investigated by legal institutions, please submit the final report or indicate the details of this legal institution.  
  • Other documents (if needed).

After receiving the documents, our customer service specialits will inform you about the process of claim investigation or additional required documents if needed.

 

 

 

Who should apply and fill in the documents?

The insured person who suffered the injury or his/her trustee if the insured is under-age. 

What documents should be submitted to the company:

  • Application for Insurance benefit – Form I-01.
  • Copy of the personal identification document (ID card or passport). In case of injured child - a copy of birth certificate.
  • Documents that confirm the insured event – medical documents proving the injury, diagnosis, treatment, etc.
  • If the insured event was investigated by legal institutions, please submit the final report or indicate the details of this legal institution. 
  • Other documents (if needed).

After receiving the documents, our customer service specialits will inform you about the process of claim investigation or additional required documents if needed.

 

 

 

Who should apply and fill in the documents?
Beneficiary in case of death of the insured.

What documents should be submitted to the company:

  • Application for Insurance benefit – Form I-01.
  • Copy of Death certificate (notary certified).
  • Copies of 2 personal identification documents of the beneficiary (notary certified).
  • Policy certificate (original).
  • Medical documents from the medical facility where insured have died or indicate the name and addresses of this medical facility.
  • If the insured event was investigated by legal institutions, please submit the final report or provide us with the details of this legal institution.
  • Other documents (if needed).

After receiving the documents, our customer service specialits will inform you about the process of claim investigation or additional required documents if needed.

 

 

Who should apply and fill in the documents?

The insured person who suffered the illness or his/her trustee if the insured is under-age. 

What documents should be submitted to the company:

  • Application for Insurance benefit – Form I-01.
  • Copy of the personal identification document (ID card or passport). In case of insured is child - a copy of birth certificate.
  • Documents that confirm the insured event – medical documents proving the illness, diagnosis, treatment, etc.
  • Names and addresses of medical facilities where illness was first time diagnosed.
  • Other documents (if needed).

After receiving the documents, our customer service specialits will inform you about the process of claim investigation or additional required documents if needed.