Become a Partner

eClaims

Step 1 of 5

Let's get started!

Thank you for your interest in becoming an Allianz Global Assistance agent. Please share the following information with us (it will take approximately 6 minutes). An Allianz Global Assistance associate will review your application and if you are approved, you will receive your account information on the next business day!

The Basics

Your new Allianz Global Assistance account
Agency Name*   Upon approval of your application, we will create an Allianz Global Assistance account for you to help get you up and running and ready to sell. Your "User ID" will be an email address. By default, the email address is the one you provided to the left, but if you wish to use a different email address, please supply it below.

User ID Email Address*
     
Doing Business As
Contact First Name*  
Contact Last Name*  
Email Address*    
Phone*    
Fax  
Address 1*  
Address 2
City*  
State*  
Zip*    
Agency URL/Website

* - Required Field


Sales Support Direct: salessupport@allianzassistance.com
1-800-284-8300 (prompt 4) ext.51635 		Hours of Operation: Monday-Friday
8:00am - 10:00pm (EST)