Claim Forms

You may easily download the following claim forms which are saved in Adobe Acrobat (PDF) format.  If you don't have Adobe Acrobat Reader, you will need to download and install that free program in order to view them.

Once you have opened a form in your browser, you may print it or save it for future use.

Download times will vary depending on the speed of your Internet connection. If you have any difficulty retrieving these files or if you have any questions, please contact us.

Claim forms must be printed and signed before they are submitted for processing. Claim processing will be delayed if they are not signed.

Trip Cancellation/Interruption Claim FormPDF244.12 KB Download
Emergency Medical/Evacuation Claim FormPDF252.25 KB Download
Baggage Delay/Loss Claim FormPDF257.17 KB Download
Beneficiary DesignationPDF54.18 KB Download
Travel Delay Claim FormPDF242.22 KB Download
Alternate Payee FormPDF203.21 KB Download
ACH Transfer Authorization and Agreement FormPDF120.52 KB Download
Accidental Death and Dismemberment Claim FormPDF124.89 KB Download