LUMA ASEAN PASS TRAVEL CLAIM FORM
GENERAL INFORMATION
For all claims, please submit: 1.
A completed and signed Travel Claim Form
2.
A copy of the Passport of the Insured with Exit and Entry Stamp, Boarding Pass and/or Travel Evidence of Insured Person
3.
Other documents as listed per Claim type (see following pages). Please note other documents may be requested by the Company on a case by case basis.
For your record, please keep a copy of every document that you submit.
If you are claiming more than one policy benefit, please complete each section as required.
If you are unable to supply one of the required documents, please explain why so that we may consider how to progress with your claim.
Please avoid sending the documents separately as they may lost in transition, resulting in a delay assessing your claims.
For claims higher than 200 USD, please send original receipts and completed claims form to: Luma Etown Building, Unit 22- 152 11 Doan Van Bo, Ward 12, District 4 HCMC, Vietnam
Contact Luma: +84 190 055 8864 claims-vn@lumahealth.com
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