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Personal Accident Insurance Claim

Claim Online

Click the button below to visit the Claim Form. Complete the form and click a button to submit it to us.

Personal Accident Claim Form

Download PDF

Step 1: Download PDF form
Step 2: Fill in details & Save PDF
  • The documents you download is a editable PDF, please fill your details directly to the form and Save! Therefore, you can easily email them back to us.

Step 3: Submit Online
  • Before submitting, please prepare all evident files and saved PDF forms. Then, please send all documents to the following email address: axathai@axa.co.th to complete your online claim.

Personal Accident Insurance Claim Guideline

1 Hospital services within contract
2 Hospital services outside contract