File a claim

File a claim
File a claim

Travel Claim Form

A. Policy Information

Policyholder's full name

Policy/Certificate No.

B. Claimant details

Full name



Mobile No.

Correspondence address

C. Travel & Loss Details

Travel Period (From)

Travel Period (To)

Travel Agency (if applicable)

Date of Loss/Accident

Location of Loss/Accident

Time of Loss/Accident

Type of Accident

Detailed description of the circumstances of the Claim

Total amount claimed

Have you made a claim against any other party in respect of this event? If yes, please provide:

Name of other party/insurance company:

Description of claim

D. Bank Account Details

Please provide your bank details for us to accelerate your claims payment process by direct transfer to your bank account.

Name (as per bank account)

Bank Code

Bank Name

Branch Code

Account No.

E. Declaration, Authorization & Customer's Data Privacy Consent

[Declaration] I/We confirm that I am/We are the claimant and/or the Policyholder and I/We declare that all the particulars given above are to the best of my/our knowledge true and correct.

[Authorization] I / We hereby consent to and authorize the medical practitioner involved in the claimant’s care to discuss and disclose treatment details and discharge arrangements with and to HSBC Life (Singapore) Pte. Ltd. I/We agree that a copy of this consent shall have the validity of the original.

[Customer’s Data Privacy Consent] In connection with my/our and/or the claimant’s claims, I/We give consent for HSBC Life (Singapore) Pte. Ltd. and their respective representatives or agents to collect, use, store, transfer and/or disclose the information (including that provided by sources other than myself) concerning me/us and/or the claimant, to or with all such persons (including any member of the HSBC Group or any third party service provider, and whether within or outside of Singapore and the Policyholder when claiming under a Group Policy) for the purpose of enabling HSBC Life and their respective representatives or agents to provide me/us and/or the claimant (where applicable) with services required of an insurance provider, including the evaluating, processing, administering and/or managing my/our and/or the claimant’s claims or the Policyholder Group Policy(ies) with HSBC Life (as the case may be), and for the purposes set out in HSBC Life’s Data Privacy Policy which can be found at (“Purposes”).

F. Documents Required for Claim Assessment

Below is a list of minimum documentation required to process your claim. In certain circumstances, additional information may be required in order for further confirmation.

Type of Loss/Accident

Documents Required (Please tick against the documents you have submitted)

Basic for all types

Basic for (plus) as applicable below:

Accidental Death, Total Permanent Disablement
Medical expenses, Hospitalisation Allowance, Hospital Visit benefit, Compassionate Visit, Child Care Benefit
Loss/ Damage to Baggage & Personal Effect
Purchase of Essential Items
Baggage Delay
Personal Money & Travel Documents
Trip Cancellation/Travel Curtailment
Trip Postponement/Replacement of Traveller
Travel Delay/Travel Diversion
Travel Overbooked or Misconnected
Fraudulent Use of Lost Credit Card
Personal Liability
Financial Collapse of Travel Agency
Rental Car Excess Cover
Emergency Personal Mobile Phone Charges
Loss of Sports Equipment, Golf Equipment, Hole-in-one Celebration
Pet Care
Quarantined Allowance for Influenza A
Hijacking Inconvenience
Kidnap & Hostage
Home Care Benefit
Study Interruption

G. Final steps

Upload Supporting Documents
Please attach the relevant supporting documents with your claims submission to expedite claim processing.

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Please review and ensure all details are accurate before you proceed.

Thank you!

Thank you for your online Travel Claim notification. Our claims officer is reviewing your submission and will update your claim status . Please quote our reference number when corresponding with us.

Please note that you may experience some delay during our peak season from July – August and from December – January. During this period you will receive our update on your claim within 21 working days