Tell us a bit about your claim
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I want to claim:Please selectIndividual PolicyGroup Policy
Remarks: eClaims support Accident, Medical and Travel claim submission.
I want to make a claim for Please select.
The claim type is Please select
Are you making a travel claim? please selectYesNo
Is the claim caused by accident? please selectYesNo
The benefit I want to claim is
Correspondence address
Country / District
Address
(只限中國使用)
Province
City
District/County/Area
Avenue/Block
Street
Address 1
Address 2
Postal Code
Maximum amount of receipt for this claim type (per submission) HKD
Remark
AIA Connect does not support inpatient claim. Please file your request in paper with a claim form and send your relevant supporting documents to AIA Corporate Solutions.
Click here to download claim form.
Tell us more details about your claim
Destination
Period of Journey (From)
Period of Journey (To)
The claim is caused by accident or illness?
Symptoms
Date of symptoms first appeared
Diagnosis
Accident Date
Accident Location
Accident Details
Part(s) of Body Hurt
Current Occupation
Job Duties
Reason for Compassionate Visit
Period of Visit (From)
Period of Visit (To)
Name of Immediate Family Member
Reason for Journey Curtailment / Cancellation
Name of Sick / Injured Person
Relationship to the Insured
Incident Details
Period of Journey Curtailment / Cancellation (From)
Period of Journey Curtailment / Cancellation (To)
Name of Companion
Date of incident
Reported Date to Police / Related Parties
Reported Time To Police / Related Parties
Please provide the reasons for not reporting the loss or damage
Remarks:
AIA will make the claim review according to individual circumstances
Item(s) Lost / Damaged
Date of Purchase / Document(s) Replacement
(Purchase) Value / Repairing Cost / Document(s) Replacement Cost and Its Currency
Reason for Travel / Baggage Delay
Expected Arrival Date
Expected Arrival Time
Actual Arrival Date
Actual Arrival Time
Flight No.
Benefit Type
Date
Time
Location
Nature of Expenses
Claimed Amount
The claim will be followed up by
You can choose a financial planner from any of your existing policies or AIA Customer Service Centre to follow the claim
Please submit the claim payment details or compensation details
Member ID
Group Policy Number
Certificate Number
We will further process your group insurance claim upon the completion of the claim assessment, if needed.
Claim Cheque Currency
For customers with FPS/e-Bankin registered with AIA, the claims payment will be deposited into the most-recently registered bank account. If neither FPS nor e-BankIn service has been registered, claim benefit will be paid by Cheque.
I / We agree the Company to deduct any balance in excess of the actual eligible discounted premium recalculated in accordance with the eligible No Claim Discount (NCD) and related levy (if any) from any insurance proceeds. (please mark “✓” in the box if disagree). Please refer to Important Note and Declaration and Authorization of NCD.
Other Information
Receipt amount *
Medication fees stated in this receipt(if any)
X-Ray & Lab fees stated in this receipt (if any)
Date of Consultation
The remaining amount in FSA for current policy period :
HK$ 1,000
Amount already paid by other insurer(s)
If you wish to submit a claim request to another insurer with this receipt, you can download the claim settlement advise from our website after the processing of this claim is completed by AIA.
Please note that doctor's referral letter might be required. Please refer to your Member Guide for more information.
Upload your claim document(s)
Please upload related document as you can. If receipt is uploaded, please submit the original receipt to AIA.
GO TO SETTING
Receipt(s)
Claim Form
Medical Report(s) / Sick Leave Certificate
ID Card Copy
Passport / Entry Proof / Travel Tickets
Unused Ticket / Deposit Receipts
Written Confirmation from Airlines / Public Common Carrier / Hotel
Colour Photo of Damaged Item
Purchase Receipts / Documents Replacement Receipts
Receipts for Additional Hotel Accommodation & Refreshments / Purchase of Necessities
Relationship Proof
Police Report
Claim Payment Details
Others
Receipt
Amount
Medication Fees
X-Ray & Lab fees
Doctor Referral Letter
Please review before submitting
Insured
###basicInfoInsured###
This incident was cause by accident?
###basicInfoClaimType###
Benefits Type
###basicInfoBenefit###
Corresponding Address
address information
###travelInfoDestination###
###travelInfoJourneyFrom###
The claims is caused by accident or illness?
###medicalExpenseType###
###illnessSymptoms###
###illnessDiagnosis###
###accidentDate###
###accidentLocation###
###accidentDetails###
###accidentBodyHurt###
###accidentOccupation###
###accidentJobDuties###
###compVisitReason###
###compVisitDestination###
###compVisitFrom###
###compVisitTo###
Family Member ###n###
###journeyCancelReason###
Person ###n###
Name of Sick/ Injured Person
###journeyCancelDetails###
###journeyCancelFrom###
###journeyCancelTo###
Companion ###n###
###journeyCancelCompanionName###
Date of Incident
###lossDate###
###lossDetails###
###lossReportDate###
Reported Time to Police / Related Parties
###lossReportTime###
The reasons for not reporting the loss or damage
###notReportedReason###
Item ###n###
###lossItemName###
###lossItemDate###
###lossItemCurrency###
###lossItemAmount###
Incident ###n###
###delayItemReason###
Expected Arrived Date
###delayItemExpectDate###
Expected Arrived Time
###delayItemExpectTime###
Actual Arrived Date
###delayItemActualDate###
Actual Arrived Time
###delayItemActualTime###
###delayItemFlightNo###
###delayPersonName###
###otherItemBenefitType###
###otherItemDate###
###otherItemTime###
###otherItemLocation###
###otherItemDetails###
###otherItemExpenseNature###
###otherItemCurrency###
###otherItemAmount###
###additionalInfoPlanner###
###additionalInfoMemberID###
###additionalInfoPolicyNo###
###additionalInfoCertNo###
###additionalInfoChequeCurrency###
###additionalInfoOtherInfo###
Medical Report(s)/ Sick Leave Certificate
I / We confirm that I / We have read and understood the AIA Personal Information Collection Statement ("AIA PIC"). I / We agree to the provision and use of my / our personal data for direct marketing purposes in accordance with the AIA PIC. I / We acknowledge and consent to the transfer of my / our personal data outside of Hong Kong (for policies issued in Hong Kong) or Macau (for policies issued in Macau), as the case may be, for direct marketing purposes and to the types of transferee as set out in the AIA PIC.
I / We confirm that I / We have read and understood the AIA Personal Information Collection Statement ("AIA PIC"). You may check the AIA Personal Information Collection Statement ("AIA PIC") on our website (https://www.aia.com.hk/en/privacy-statement.html) I / We agree to the provision and use of my / our personal data for direct marketing purposes in accordance with the AIA PIC. I / We acknowledge and consent to the transfer of my / our personal data outside of Hong Kong (for policies issued in Hong Kong) or Macau (for policies issued in Macau), as the case may be, for direct marketing purposes and to the types of transferee as set out in the AIA PIC.
The use of eClaims at or under AIA Connect shall at all times be governed by the Declaration and Authorization.
Please click the "Submit" button for your confirmation of the above declaration.
Claim Type
Receipt Amount
###basicInfoReceiptAmount###
Medication fees stated in this receipt (if any)
###basicInfoMedicationFeesPreview###
###basicInfoXrayFeesPreview###
###DateofConsultationPreview###
###DiagnosisPreview###
Amount already paid by another insurer(s)
###AlreadyPaidPreview###
###ReceiptAmountPreview###
###ReceiptDatePreview###
###ReceiptFeesPreview###
X-Ray & Lab Fee
###XrayFeesPreview###
Important Notes
Please read carefully before your submission: