Monzo Travel

Monzo Premium travel insurance claim form
News for Monzo users impacted by the air traffic disruption in the UK

Unfortunately, any cancelled or delayed flights or other related cancellations because of the air traffic disruption in the UK over the August bank holiday weekend and subsequent days are not covered under the insurance policy.

Your airline, however, owes you a ‘duty of care’
-Under UK law you have legal rights which oblige the airlines to provide support to their customers flying from a UK airport, arriving in the country on an EU or UK airline, or arriving at an EU airport on a UK airline.
-If the flight is covered under UK law, the airline must give the option of choosing another flight or providing a full refund. You can get money back on any part of the ticket not used.
-If you still want to travel, the airline must find you an alternative flight. If another airline is flying to your destination significantly sooner, or there are other suitable modes of transport available, then you have a right to be booked onto that alternative transport instead.

You can also refer to other online sources :
UK Civil Aviation Authority
The Times
Please provide your Policy ID*
Is policy pre-fill (1=yes)
Date of incident*

DayMonthYear
If you subscribed to Monzo Premium before the 3rd of July 2023 and your incident took place prior to the 2nd of August 2023, you need to file a claim with AXA. You can do so by :

Calling : +44 (0) 203 701 9629
Filing the AXA travel form at : uk.claims.axa.travel

If you became a Monzo Premium user after the 3rd of July you are not impacted by this.
What would you like to claim for?*
Please select your injury*
ref_country
claim_type
What happened ?*
In case of emergency please contact Zurich Assistance directly for assistance support : +44 (0) 20 8156 2610
Have you already contacted them? Please provide the claim reference.
What happened ?*
What happened ?*
What happened ?*
This coverage is limited to claims where the customer suffers an accident during their trip resulting in an injury which directly results in:
- Death
- Loss of sight
- Loss of limb
- Permanent total disablement
For claims requiring medical evidence, please use the medical certificate template provided by us and available here. Please share this certificate to your general practitioner.
Who did you travel with?*
Are you claiming for yourself or on behalf of the family members who travelled with you?*
insurer
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claim email
claim_subtype
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Check your eligibility
You won't be able to make a claim if any of these situations apply to you:

-If you were not a Monzo Premium cardholder at the incident date.
-Trips that are longer than 45 days.
-Trips in the UK that are less than 100 km from your home.
-When you reach the age of 71, cover will continue until the next anniversary of your Monzo Premium account but not thereafter.
-Trips to an area where the FCDO or regulatory authority in a country to/from which you are travelling has advised against all or all but essential travel.
-Any fines or penalties against you.
-Rental vehicles or drivers not named in the rental agreement.
-Any rebooking costs that exceed the cost of your originally booked trip.
-Any claim resulting from the delay or change to your booked trip because of Government action or restrictive regulations.

You can find more information regarding your flight cancellation rights here: https://www.euclaim.com/regulation-261-2004
Policyholder identification
Please provide your Policy ID*
This is the number starting with M-MZO and followed by 14 digits (e.g M-MZO5196780-0000001)
We will not be able to process your claim without a correct Policy ID.
We believe you have inputted the wrong Policy ID. Your Policy ID is the combination of the Master Policy number (M-MZO5196780) and your individual Policy number (1234567). They should not be the same number.

Please verify that you have shared the correct Policy ID. You can find your Monzo Travel policy number in the travel insurance section of your Monzo app. It looks like this: M-MZO5196780-1234567.
We believe you have inputted the wrong Policy ID. Your Policy ID is the combination of the Master Policy number (M-MZO5196780) and your individual Policy number (1234567). Please verify that you have shared the correct Policy ID. You can find your Monzo Travel policy number in the travel insurance section of your Monzo app. It looks like this: M-MZO5196780-1234567.

Do you have these documents?
We'll ask you to upload these documents later in this form. If you don't have them, we won't be able to process your claim.
Travel cancellation (before departure)
Cancellation coverage protects you in case you unavoidably have to cancel or rebook your trip prior to departure of your round trip for any of the covered reasons. Cancellation of flights by the airline carrier are not in scope of this coverage. If your flight is delayed or cancelled and therefore you end up arriving at your destination 3h late or more than the original scheduled arrival time, under EU261 Regulation you can claim for compensation with your airline carrier according to this EU regulation.

You can also find more information regarding your flight cancellation rights here: https://www.euclaim.com/regulation-261-2004
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.

You will need to provide cancellation invoices for each element, this must include the date you cancelled, the charges to cancel and any refunds or credits offered to you.
Invoice for unused pre-paid excursions

Original booking invoice for any unused pre-paid excursions confirming date and amount paid.
Medical certificate

In case of injury or illness, we require a medical attest describing your injury or illness. Please ask your general practioner (or the medical professional treating you) to fill the medical certificate template we have provided you here.
Trip cancellation

If you cancel your trip because of a 24h delay on your outward journey, please provide a written report from the carrier confirming the length and reason for the delay. The transport carrier can issue this proof for you.
Other proof of cancellation

If you claim relates to covered circumstance that are not medical, you will be required to provide documents relevant to your peril.
Travel curtailment (cancelled whilst abroad)
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.

You will need to provide cancellation invoices for each element, this must include the date you cancelled, the charges to cancel and any refunds or credits offered to you.
Invoice for unused pre-paid excursions

Original booking invoice for any unused pre-paid excursions confirming date and amount paid.
Booking invoice for a new flight

Original receipt or booking invoice for new flight
Medical certificate

In case of injury or illness, we require a medical attest describing your injury or illness. Please ask your general practioner (or the medical professional treating you) to fill the medical certificate template we have provided you here.
Other proof of cancellation

If you claim relates to covered circumstance that are not medical, you will be required to provide documents relevant to your peril.
- Proof that emergency services requests you to return home in case of serious damage to your home or business or;
- Proof that you authorised leave (as an employee of a Government Department) was cancelled for an unexpected posting or an emergency.
Delayed departure
If your flight is delayed or cancelled, and therefore you end up arriving at your destination 3h late or more than the original scheduled arrival time, under EU261 Regulation you can claim for compensation with your airline carrier according to this EU regulation.
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Proof of delay

We require the proof that your travel has been delayed including the delayed schedule, and the cause. The transport carrier can issue this proof for you.
Invoice or receipt for emergency purchases.

Original receipts for purchases of refreshments and meals, or additional accommodation if necessary.
Missed departure
If your flight is delayed or cancelled, and therefore you end up arriving at your destination 3h late or more than the original scheduled arrival time, under EU261 Regulation you can claim for compensation with your airline carrier according to this EU regulation.

You can also find more information regarding your flight cancellation rights here: https://www.euclaim.com/regulation-261-2004
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Booking invoice for an additional accomodation and/or travel expenses.

Original receipt or booking invoice for an additional accomodation (room only) and travel expenses outside the UK in the attempt to reach your international travel destination.
Proof of missed departure

We require proof of your missed departure. Depending on the peril you will have to provide one of the following:
- Failure of public transport - letter confirming length and reason of delay.
- Breakdown - report from the breakdown company showing date and what was wrong with vehicle.
- Motorway problem - Highways agency printout of that date or written confirmation from the police showing location, duration and reason for delay.
Baggage delay
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Luggage delayed

We require the certificate from the carrier that your luggage has been delayed. This is covered by a Property Irregularity Report (PIR) from the carrier or their handling agents. The report should confirm the reason and length of delay and when item(s) were returned to you.
Invoice or receipt for emergency purchases.

Original itemised receipts for any emergency purchases made.
Baggage loss, theft or damage
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Baggage lost or damaged by the carrier

If your baggage was lost or damaged by the carrier, we require a Property Irregularity Report (PIR) from the carrier or their handling agents confirming the incident. If the baggage was lost by the carrier, please provide a written statement from the carrier confirming they have stopped looking for baggage and it is deemed irretrievably lost.
Police report

In case of theft or lost items. We require a police report confirming you reported the incident to the police within 24 hours of noticing the item(s) missing.
Damage report and repair estimate for damaged items.
- In case your item is repairable, we require a quote from any repair shop
- In case your item cannot be repaired, we require a formal statement that the item cannot be repaired from any repair shop.
Pictures of damaged item

In case of damage, we require picture(s) showing to what extent this item has been damaged. Keep any damaged items beyond repair as we may need to inspect them.
List of items

Itemised list all valuables lost, damaged or stolen including the date of purchase. made.
Proof of ownership

We require all invoices and receipt to proving your ownership on the items your are claiming for.
Personal money
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Personal money

If personal money was lost or stolen a police report confirming what happened and what was lost, and any bank statements/bureau de change receipt as proof of ownership.
Travel documents
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Official missing report

Police report or embassy report confirming you reported to the local authorities within 24 hours of noticing the passport missing.
Invoice or receipt for emergency purchases.

Original receipts for any additional accommodation or travel expenses incurred.
Mugging
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Police report

A police report with an incident number that confirms that you reported the mugging within 24 hours.
List of items

Itemised list of personal possessions stolen/damaged/lost including date of purchase and amount paid.
Witness report

An official statement from a witness describing the circumstances of the mugging dated and signed, with the full name of the witness, date of birth, address and employment, passport or driving licence.
Medical certificate

If you require any medical treatment please obtain a written medical report from the medical practitioner.
Overseas medical expenses
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Medical certificate

Please keep all original receipts and obtain a medical report from the hospital confirming the illness or injury, any treatment and admission and discharge dates if applicable.

If you were not hospitalized, a medical report from your medical practitioner confirming the treatment and medical expenses. Please use the medical certificate provided by us here.
Invoice or receipt for emergency purchases.

Original receipts for any additional accommodation or travel expenses incurred.
Outstanding medical bills

If there are any outstanding expenses please send a copy of the outstanding bill. Please also mark on it that it remains outstanding. Similarly, if you incur any additional expenses after our prior authorisation, please provide these receipts.
Dental
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Medical report

Medical report from dentist confirming the cause of treatment and whether this was due to relief of pain or trouble eating
Dental invoice

Itemised invoice for your dental treatment.
Outstanding dental bills

If there are any outstanding expenses please send a copy of the outstanding bill. Please also mark on it that it remains outstanding.
Hostpital benefits
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Hospital report

Please keep all original receipts and obtain a medical report from the hospital confirming the illness or injury, any treatment and admission and discharge dates.
Liability
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Liability

Detailed explanation of the circumstances surrounding the incident, including any photographs and video evidence (where applicable).

Every writ, summons, or other correspondence received from a third party.

Full details of any witnesses, providing written statements where possible.
Personal accident
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Medical report

Please keep all original receipts and obtain a medical report from the hospital confirming the illness or injury, any treatment and admission and discharge dates if applicable.

If you were not hospitalized, a medical report from the medical practitioner confirming the treatment and medical expenses. In case of death, please provide a death certificate.
Overseas legal expenses
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Legal expenses

Detailed explanation of the circumstances surrounding the incident, including any photographs and video evidence (where applicable).

Any writ, summons, or other correspondence received from a third party.

Full details of any witnesses, providing written statements where possible.
Hijack
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Winter sports
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Invoice or receipt for extra transport or accomodation

Invoices or receipts for any accommodation or transports costs incurred in the event of piste closure or avalanche or landslide closure.
Police report

If lost or stolen a police report confirming you reported the incident to the police within 24 hours of noticing the item(s) missing.
List of your items

We require the list of all your items and all invoices and receipts to justify them.
Pictures of damaged item

In case of damage, we require picture(s) showing to what extent this item has been damaged. Keep any damaged items beyond repair as we may need to inspect them.
Damage report and repair estimate for damaged items.
- In case your item is repairable, we require a quote from any repair shop
- In case your item cannot be repaired, we require a formal statement that the item cannot be repaired from any repair shop.
Written confirmation by your rental or skipass provider

We require a letter from the seller or renter of the ski pack that proves no refund was granted.
Piste & resort closure

Written confirmation from the resort management confirming the closure of facilities and the dates applicable.
Avalanche or landslide closure

Written confirmation from the resort management confirming the closure of facilities and the dates applicable.
Medical certificate

Written confirmation from a medical practitioner that the bodily injury or illness stopped the use of the ski pack. Please ask your general practioner (or the medical professional treating you) to fill the medical certificate template we have provided you here.
Car excess
Invoice or receipt for the trip

Full booking invoice(s) for each part of your booked trip. This must include the date you booked/paid, the travellers, the destination and the amount charged to you.
Car rental documents

We require the copy of the car rental contract and the proof that you had to pay the waiver to the renter.

Accident report

The accident report describing the extent of the damage and the circumstances.

Communications with the rental company

Any communication with the rental company related to your waiver.

Incident details

Please provide details regarding your incident
Incident country*
Incident city*
Incident location*
Please describe where your incident took place. E.g in the street, name of the airport, etc.
Please describe the incident*
Do you have another insurance covering the same incident?*
Provide the name and case references (if any) of your other insurance.*
By cliking next you confirm that all the information you have provided is accurate and complete to the best of your knowledge. Submitting false or misleading information may be considered fraud, which could result in the denial of your claim and further action being taken.
Journey details

Please provide the details of your journey as they were originally booked.
Departure country*
Departure city*
Departure date and time*

DayMonthYear
Date
hour : minutes
Destination country*
Destination city*
Return date and time*

DayMonthYear
Date
hour : minutes
Type of transport*
Transport number*
E.g flight number, train number, etc.
Please upload your original booking invoices and travel documents showing the dates of travel and booking.*

If applicable, invoices should show the names of the family members travelling with the cardholder.
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Please upload your original cancellation invoice(s) detailing all cancellation charges incurred and any refunds given.*

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Travel inconvenience
Baggage and valuables
Mugging
What happened to your baggage or valuables?*
Why was you trip was canceled?*
Why was you trip was curtailed?*
Did you contact Zurich Assist?*
Please share the reference of your assistance case
Did Zurich Assist organise your travel home?*
Why was you departure delayed?*
Why did you miss your departure?*
If you are not filing a claim for one of the reasons listed above, the event you encountered is not covered by your Monzo travel coverage. You can refers to your Coverage Terms and conditions or to our frequently asked questions.
Itemised list of all baggage items lost/damaged/stolen, please include the date of purchase and amount paid.*
Please indicate the total amount in £ your are claiming for *
This amount is purely indicative. The total compensation will be based on the replacement value of your item and/or the benefit table available in the Terms and Conditions
Cancellation date*

DayMonthYear
Please indicate the date on which you had to cancel your trip.
Duration of the delay (in hours)*
After a 24 hours’ delay on your outward journey you may choose to submit a cancellation claim. We remind you that a refund or alternative compensation must initially be sought from the travel provider.
Please provide evidence of the reason your trip was cancelled.*

Cancelof
In case of cancellation due to a 24h delay, please provide a written confirmation from the carrier (or their handling agents) confirming the length and reason for the delay.
Please upload the medical certificate filled by your general practitioner. *

The medical certificate template can be found at the beginning of this form or at monzo@qover.com
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Is your claim linked to a pre-existing medical condition?*
Please provide evidence of the reason your trip was delayed.*

Cancelof
Please provide a written confirmation from the carrier (or their handling agents) confirming length and reason for delay.*

Cancelof
Please provide a written confirmation from the carrier that you missed your flight and that no refund was offered.*

Cancelof
Did you require medical treatment ?*
Please provide a short description of the illness or injury.*
Please upload medical bills or report confirming the treatment provided and cost.*

Cancelof
Please provide evidence of the reason your missed your departure.*

Cancelof
Was your item lost or damaged by the carrier?*
Please upload proof that your baggage was delayed.*

Please provide a Property Irregularity Report (PIR) form the carrier or their handling agents and a letter from the airline confirming the reason and length of delay and when items were returned to you.
Cancelof
Please upload proof that your baggage was damaged or lost by the carrier.*

Please provide a Property Irregularity Report (PIR) form the carrier or their handling agents and a letter from the airline.
Cancelof
Please upload a police report.*

In case of mugging, please include witness statements.
Cancelof
Please provide proof that baggage or valuables were damaged.*

Please share a picture of your damaged item.
Cancelof
Is the damage on your item beyond repair?*
Please provide a damage report from a repair shop.*

This document should show the level of damage and the repair estimate if repairable. Please keep any damaged items beyond repair as we may need to inspect them.
Cancelof
Please provide receipts or proof of ownership for stolen, lost and damaged items.*

Cancelof
Please provide original receipts for all emergency purchases made.

If applicable, please include new travel invoices purchased to reach your final destination.
Cancelof
Please provide original receipts for expenses incurred to return home.*

(e.g new flight booking)
Cancelof
Did you receive a compensation from the carrier?*
Amount in £ received in compensation from the carrier.*

Personal money
What happened to your personal money?*
Please provide and any bank statements/bureau de change receipt(s) as proof of ownership.*

Cancelof
Please upload a police report.*

If you lost your valuable, please provide a police report.
Cancelof

Travel documents
What happened to your travel documents?*
Please upload a police report or report from your embassy.*

The document should show you reported to the local authorities within 24 hours of noticing the passport missing.
Cancelof
Please provide original receipts for any additional accommodation or travel expenses incurred.*

Cancelof

Car excess
We're sorry to hear that something went wrong with your car rental. Please provide the following documents so we can process your claim.
Please indicate the total amount in £ of your rental excess. *
This amount is purely indicative. The total compensation will be based on the benefit table available in the Terms and Conditions
Accident report*

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Car rental contract*

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Email communications with the rental company

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Bank statement or original receipt showing how much you have paid for the damages*

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Winter sports
What happened to your equipment ?*
Please itemise the unused lift pass, school fees and hired equipment costs claimed.*
Please describe your injury or illness.*
Medical certificate confirming that the bodily injury or illness stopped the use of the ski pack. *

The medical certificate template can be found at the beginning of this form or at monzo@qover.com
Cancelof
Damage report and repair estimate for your damaged winter sport equipments. *

Keep any damaged items beyond repair as we may need to inspect them.
Cancelof
Please provide pictures of your damaged items. *

Cancelof
Provide your rental invoice or proof of ownership for your equipment.*

Cancelof
Please provide the invoice of your unused ski pack (ski rental, ski pass etc.).*

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Written confirmation from the business you purchased the ski pack through and that no refund is available for the unused elements.*

Cancelof
Police report confirming you reported the incident to the police within 24 hours of noticing the item(s) missing.*

Cancelof
Description of the piste closure event or avalanche or landslide closure.*
Please provide the invoice for additional cost incurred in case of piste or avalanche closure (e.g cost of transport, lift pass, extra accommodation).*

Cancelof
Written confirmation from your ski resort of the closure of facilities and applicable dates.*

Cancelof

Liability
Please remember that your Personal Liability coverage applies for legal liability claim incurred by you while on a trip outside of the UK in respect of:

a) accidental injury, death or illness of any person who is not in your employment or who is not a relative, close relative or member of your household.

b) accidental loss of or damage to the property of any person.

c) any claimant’s costs and expenses arising out of the above which you or your representatives are legally liable to pay.
Please select the type of liability *
Please provide a detailed description of the incident and its circumstances.*
Please provide pictures of the damages the damages caused to the property of the third party. *

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Please provide written statements from any witness, police authority and/or the third party. *

Please include full details of any witnesses, providing written statements where possible.
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Third party contact details

Please provide the contact details of the third party in regards to your liability claim
Full name*

First NameLast Name
Email*
example@example.com
Phone number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country

Medical expense abroad
In case of emergency please contact Zurich Assistance +44 (0) 20 8156 2610. If you didn't require assistance service and/or still have outstanding medical bills following an incident overseas, you can use this form to get compensated for the remaining amount.
Is your claim linked to a pre-existing medical condition?*
Please describe your pre-existing medical condition*
Did you use Zurich Assistance prior to filing your claim with us?*
Please share the reference of your assistance case reference *
Were you hospitalised? *
Hospitalisation start date*

DayMonthYear
Date
Hospitalisation end date*

DayMonthYear
Date
Please describe your injury or illness.*
Please provide a medical certificate confirming illness or injury, any treatment and admission and discharge dates if applicable.*

The medical certificate template can be found at the beginning of this form or at monzo@qover.com
Cancelof
Do you have any outstanding medical bills?*
Cost of your outstanding medical bill*
Please select the currency*
Please provide a copy of all outstanding hospital bills. *

Please mark on it that it remains outstanding.
Cancelof
If applicable, please provide any other medical bills and invoices for the costs you incurred.

Cancelof
If applicable please provide receipts for all the costs of transporting you to the nearest suitable hospital.

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Did you have to interrupt your trip (return to the UK early) due to your injury or illness?*

Personal accident
Please provide a detailed explanation of the circumstances surrounding the incident, providing written statements of witnesses (and their details) where possible.*
Please describe your injury.*
Please provide a medical certificate from the medical practitioner to confirm the extent of the injury and treatment given including hospital admission/discharge, or a death certificate if applicable.*

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Legal expenses
Please remember that your Overseas Legal Expenses coverage covers the legal costs in civil pursuits of a claim against a third party for damages or compensation in respect of your injury, dealth or illness sustained while on a trip.

You have the right to appoint a suitably qualified legal representative in connection with any claim or legal proceedings including the appointment of an expert witnesses.

Our consent to pay legal expenses must be obtained in writing prior to costs being incurred or legal action is taken.
Please provide detailed explanation of the circumstances surrounding your civil pursuit.*
Please highlight the reasonable grounds for pursuing or defending the legal proceedings.
Please provide any writ, summons, correspondence receive from a third party, details of any witnesses, providing written statements where possible.*
Please highlight the reasonable grounds for pursuing or defending the legal proceedings.
You can provide any supporting evidence here.

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Family information

If you’re claiming on behalf of family members who travelled with you.
Your and your partner's children are covered if they are:
• 19 years old or under at the start of the trip or 21 years old or under at the start of the trip if they are in full-time education
• Financially dependent on the cardholder or partner (according to UK regulations)
• Not married
Partner's first name and last name*
Partner's date of birth*

DayMonthYear
Date
How many children did you travel with ?*
Child's first name and last name*
Child's date of birth*

DayMonthYear
Date
Child's first name and last name*
Child's date of birth*

DayMonthYear
Date
Child's first name and last name*
Child's date of birth*

DayMonthYear
Date
Child's first name and last name*
Child's date of birth*

DayMonthYear
Date
Child's first name and last name*
Child's date of birth*

DayMonthYear
Date
Please provide the first and last name and date of birth of each of the children that travelled with you*
claimant_entityType
Cardholder information
Name*

First NameLast Name
Email*
Phone number*
Date of birth*

DayMonthYear
claimant_address_country
Bank account details

Please provide us with the account number and sort code of the account where you would like to be paid if your claim(s) is successful.
Account number*
8 digits
Sort code*
6 digits

Qover privacy notice
Your personal data will be collected and processed by Qover SA (hereinafter ‘Qover’) that is independent controller responsible for the processing of the personal data you are required to share when you submit your claim. The data will be processed only for the purpose of the use of the services provided by Qover, including risk assessment, insurance contract management, claims handling and crime prevention (such as fraud) as well as to allow Qover to fulfill its legal obligations. Qover may disclose personal data to third parties, such as service providers, subcontractors, or to our partners such as Monzo, for the same purposes. Furthermore, Qover might disclose personal data to the risk carrier, Zurich and healthcare professionals for claims handling purposes. For more information about how Zurich processes personal data please visit here. Personal data may be transferred abroad, including to countries outside the European Economic Area. Such transfers are subject to appropriate safeguards, including contractual safeguards, in accordance with applicable European regulations. The persons concerned have certain rights relating to their personal data and in particular the rights of access, rectification, erasure or restriction of processing or to object to processing as well as the right to data portability. To exercise these rights, you may contact at any time by writing Qover’s DPO at privacy@qover.com. For further information about how Qover processes your data please visit our Privacy Policy - EN.
I hereby provide my explicit consent to the processing of my medical data I provide in this claim submission form.
I have read and agree to the information provided and Qover Privacy Policy.
I hereby declare that I have answered the questions to the best of my knowledge, accurate, in accordance with the truth and not to have concealed any information relating to this claim;
I am aware of the stipulation that any right to benefit may lapse with an untrue statement;
I have knowledge of the contents of this form.
I confirm
Should be Empty:

Monzo Premium travel insurance claim form

Check your eligibility

Policyholder identification

Do you have these documents?

Incident details

Journey details

Travel inconvenience

Baggage and valuables

Mugging

Personal money

Travel documents

Car excess

Winter sports

Liability

Third party contact details

Medical expense abroad

Personal accident

Legal expenses

Family information

Cardholder information

Bank account details

Qover privacy notice