Cruise Travel Insurance Claim Form
Policy Holder Details
Full Name
Date of Birth
Policy Number
Email Address
Phone Number
Address
Cruise Details
Cruise Line
Booking Reference
Departure Date
Return Date
Claim Details
Type of Claim
Trip Cancellation
Trip Interruption
Medical
Baggage
Travel Delay
Other
Amount Claimed
Description of Incident/Reason for Claim
Bank Details (for payment)
Account Name
Bank Name
Account Number
BSB/Sort Code
Declaration
Name
Date
Signature