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TRV4(0920) : ( ) : ___________________________________ / : _____________________________________________ : ________________________________________ : _________________________________________ : ______________________________________________ : ______________________________________________________ : __________________________________________ : __________________________________________________ : _____________________________________________________________________________________________________________ : __________ __________ ___________ __________ __________ ___________ ( ) : ____________________________________________________________________________________ ( ) : _______________________________________________________________________________ ( ) : _______________________________________________________________________________ ( ) : _________________________________________________________________________________ ____________________________________________________________________________________________________________ ( ) : __________________________________________________________________________________________________ : ( ) : ____________________________________________________________________________________ ( ) / : _____________________________________________________________________________ ( ) / : ___________________________________________________________________________________ ( ) : __________________________________________________________________________________________________ ( ) : __________________________________________________________________________________________________ : ( ) ( ) (a) ( ) (b) / ( ) ( ) ( ) / / www.hl-insurance.com ( ) / / / : ________________________________________ : _________________________________________________

Travel (Travel & Baggage Delay) Claim Form · Travel (Travel & Baggage Delay) Claim Form Author Giggs Leung Created Date 3/13/2020 4:51:16 PM

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Page 1: Travel (Travel & Baggage Delay) Claim Form · Travel (Travel & Baggage Delay) Claim Form Author Giggs Leung Created Date 3/13/2020 4:51:16 PM

TRV4(0920)

: ( )

: ___________________________________ / : _____________________________________________

: ________________________________________ : _________________________________________

: ______________________________________________ : ______________________________________________________

: __________________________________________ : __________________________________________________

: _____________________________________________________________________________________________________________

: __________ __________ ___________ __________ __________ ___________

( ) : ____________________________________________________________________________________

( ) : _______________________________________________________________________________

( ) : _______________________________________________________________________________

( ) : _________________________________________________________________________________

____________________________________________________________________________________________________________

( ) : __________________________________________________________________________________________________

:

( ) : ____________________________________________________________________________________

( ) / : _____________________________________________________________________________

( ) / : ___________________________________________________________________________________

( ) : __________________________________________________________________________________________________

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:

( ) ( ) (a) ( )

(b) /

( ) ( ) ( ) / /

www.hl-insurance.com ( ) / /

/

: ________________________________________ : _________________________________________________