Claim Submission Form

SPEEDHOME

Allianz Insurance Claim Submission Form
Upon submission of this form, SPEEDHOME's Operation Department will begin the claiming process and will request the supporting documents from landlords. If you wish to follow up the claim progress, please WhatsApp to https://wa.me/60166248225 or email to [email protected]
Landlord's Details
Tenant's Details
Claim's Details
When did the tenant moved out of the house?
When did you being informed that your tenant left the house?
What are you claiming?*
- Loss of Rental
- Inconvenience Benefit (Electricity, Water, Cleaning, Minor Repair)
- Household Contents Lost & Damages(furniture)
Declaration*
- I/We hereby declare the foregoing particulars to be true in every respect and that no information has been suppressed and that the sum claimed as set out overleaft represent represent the amount I/we entitled to claim in term of the policy and the Instructions contained herein.

Report Abuse

SPEEDHOME

Allianz Insurance Claim Submission Form