ASSUREX e-Claims
Medical Claims Assistance
+ 961 3 293299
e-Claims
Get a Quote
Motor Claims Assistance
+ 961 1 208181
Home
Our Company
Our Product Lines
Our Reinsurers
Careers
Contact us
Online Services
e-Payment
e-Payment
e-Claims
Get a Quote
Home
>
Online Services
> e-Claims
Send to a friend
Close
Your Email
Your Friend Email
Insured Information
First Name
*
Last Name
*
Father's Name
Address
*
Email
*
Mobile Number
*
select
+011
+1
+20
+212
+213
+216
+218
+220
+221
+222
+223
+224
+225
+226
+227
+228
+229
+230
+231
+232
+233
+234
+235
+236
+237
+238
+239
+240
+241
+242
+244
+245
+246
+248
+249
+250
+251
+252
+253
+254
+255
+256
+257
+258
+260
+261
+262
+263
+264
+265
+266
+267
+268
+269
+27
+290
+291
+297
+298
+299
+30
+31
+32
+33
+34
+350
+351
+352
+353
+354
+355
+356
+357
+358
+359
+36
+370
+371
+372
+373
+374
+375
+376
+377
+378
+379
+380
+381
+382
+383
+385
+386
+387
+389
+39
+40
+41
+420
+421
+423
+43
+44
+45
+46
+47
+48
+49
+500
+501
+502
+503
+504
+505
+506
+507
+508
+509
+51
+52
+53
+54
+55
+56
+57
+58
+590
+591
+592
+593
+594
+595
+596
+597
+598
+599
+60
+61
+62
+63
+64
+65
+66
+670
+672
+673
+674
+675
+676
+677
+678
+679
+680
+681
+682
+683
+685
+686
+687
+688
+689
+690
+691
+692
+7
+81
+82
+84
+850
+852
+853
+855
+856
+86
+880
+886
+90
+91
+92
+93
+94
+95
+960
+961
+962
+963
+964
+965
+966
+967
+968
+970
+971
+972
+973
+974
+975
+976
+977
+98
+992
+993
+994
+995
+996
+998
Phone Number
*
select
+011
+1
+20
+212
+213
+216
+218
+220
+221
+222
+223
+224
+225
+226
+227
+228
+229
+230
+231
+232
+233
+234
+235
+236
+237
+238
+239
+240
+241
+242
+244
+245
+246
+248
+249
+250
+251
+252
+253
+254
+255
+256
+257
+258
+260
+261
+262
+263
+264
+265
+266
+267
+268
+269
+27
+290
+291
+297
+298
+299
+30
+31
+32
+33
+34
+350
+351
+352
+353
+354
+355
+356
+357
+358
+359
+36
+370
+371
+372
+373
+374
+375
+376
+377
+378
+379
+380
+381
+382
+383
+385
+386
+387
+389
+39
+40
+41
+420
+421
+423
+43
+44
+45
+46
+47
+48
+49
+500
+501
+502
+503
+504
+505
+506
+507
+508
+509
+51
+52
+53
+54
+55
+56
+57
+58
+590
+591
+592
+593
+594
+595
+596
+597
+598
+599
+60
+61
+62
+63
+64
+65
+66
+670
+672
+673
+674
+675
+676
+677
+678
+679
+680
+681
+682
+683
+685
+686
+687
+688
+689
+690
+691
+692
+7
+81
+82
+84
+850
+852
+853
+855
+856
+86
+880
+886
+90
+91
+92
+93
+94
+95
+960
+961
+962
+963
+964
+965
+966
+967
+968
+970
+971
+972
+973
+974
+975
+976
+977
+98
+992
+993
+994
+995
+996
+998
Driver Information
First Name
*
Last Name
*
Date of Birth
*
Driving License
*
Browse
Insured Vehicle Information
Policy Number
*
Vehicle Plate Number
*
Registration Card
*
Browse
Accident Information
Date
*
Time
*
Location of Incident
*
Expert Name
Other Expert Name
Insured vehicle photos
*
Browse
Other vehicle photos
Browse
Location photos
*
Browse
Comments
*
*
Fields are mandatory
Submit
Upload Photos
You can upload multiple photos
If you click on "Choose Files" and select new files, this will override your previous selection
File size should not exceed 1 MB
You can upload only images of type: jpg, png, jpeg, bmp,gif