Apr 14, 2016
Allianz - hero-user
File a Claim
Since your claim has already been submitted, you cannot make changes.
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Your Policy {{policyIdString}}{{canceledStatus}}

The policy you are trying to access could not be found. You are not able to file a claim on an unknown policy.

Your Policy {{policyIdString}}{{canceledStatus}}

Please review your contact information below. If anything has changed, you can update it now.

Contact Information

  • {{ClaimTypeValues.fullName}}

  • Address 1 is required.
  • City is required.
  • State is required.
  • ZIP Code is required.
    Please enter valid ZIP Code.
  • Primary Email is required.
    Please enter valid Primary Email.
  • Telephone Number is required.
    Please enter valid Telephone Number.

Policy Details

  • {{ClaimTypeValues.policyPlanDepartureDate | myDate}}

  • {{ClaimTypeValues.policyPlanReturnDate | myDate}}

  • Please enter valid Departure Date.
  • 📅
    Please enter valid Return Date.

Claim Details

Did the incident occur during your trip (i.e. after your original departure date)?

Question above is required.

Type of Claim

Select the claim type(s) below that best fits why you are filing a claim. For a description, click the “?” next to each claim type. If you need to file for multiple incidents during the same trip, you can select more than one claim type.

  • ?
  • ?
  • {{coverage.Name}}
BillType selection is required. Please check at least one box above.

Please correct the errors above.