Kindly fill the form below
Passenger Name(s)
*
Passenger Name is Required
PNR
*
PNR is Required
Telephone Number
*
Telephone is Required
Please enter 11 digit Phone Number
Email Address
*
Email Address is Required
Invalid email address
NIN
*
NIN is Required
Date of Incident/Loss
*
Date of Incident/Loss is Required
Flight Number
*
Flight Number is Required
Actual Date of Flight
*
Actual Date of Flight is Required
Ticket Number
*
Ticket Number is Required
Certificate Number
*
Certificate Number is Required
Details of claim (Please Tick)
*
Personal Accident
Flight Cancellation/Delay
Emergency Medical Expenses
Baggage Delays
Detailed statement of incident/loss
*
Detailed statement of incident/loss is Required
Boarding pass
*
Upload of Boarding pass is Required
Please select a valid Word,image or PDF File.
File Size Exceeds 4MB
Insurance certificate
*
Upload of Insurance certificate is Required
Please select a valid Word,image or PDF File.
File Size Exceeds 4MB
Cancellation email/sms from the Airline
*
Upload of cancellation email/sms from the Airline is Required
Please select a valid Word,image or PDF File.
File Size Exceeds 4MB
Any other relevant information
File Size Exceeds 4MB
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FLIGHT DETAILS
Passenger Name(s):
Phone Number:
Email Address:
PNR(s):
NIN:
Date of Loss:
Flight Number:
Actual date of flight:
Ticket Number:
Certificate Number:
DETAILS OF CLAIM
Detailed statement of loss