Travel Health Insurance Claim Tracker

Claimant & Policy Information

Full Name

Policy Number

Insurance Company

Incident Details

Date of Incident

Country Where Incident Occurred

Brief Description of Incident

Medical Expenses Log

Total: $0.00

Documentation Checklist

Completed Claim Form

Itemized Medical Bills

Proof of Payment (Receipts)

Doctor's/Hospital Report

Prescription Receipts

Copy of Passport/Visa

Claim Summary & Download

Once you have filled out all the details, you can download a complete summary of your claim for your records. This PDF will contain all the information you entered above.