Axo - AIG FNOL (PRD)

Claim Type
Country*
ref_country
claim_language
incident_date

DayMonthYear
What type of claim do you wish to submit?*
claim_type

Claimant information

Please provide us the following details about the claimant
Information about the deceased

Please provide us with the following information about the deceased
claimant_entityType*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Country codePhone Number
Birthdate*

DayMonthYear
Policy number*
You have received your policy number in your "Welcome email". This is either a 7-digit number or a number starting with "P-AXO" followed by 7 digits.
ID number*
ID number*
ID number*
ID number*
id_number
Address of the Claimant
Address street*
Street number*
Postal code*
City*
Country*

Involuntary loss of employment
When were you hired?*

DayMonthYear
Do you work full time?*

YesNo
How many hours a week?*
When were you notified about the termination of employment?*

DayMonthYear
When did the terms of employment come to an end?*

DayMonthYear
What was the reason for the terms of employment ending?*
What type of employment did you have?*
Country of employment?*
Are you self-employed?*

YesNo
Please upload the necessary documents
Employment contract*

Cancelof
Document confirming the termination with reason and date*

Cancelof
Document confirming that you are fully entitled to unemployment benefits*

Cancelof
Document confirming payment of unemployment benefits*

Cancelof

Death
Information relating to the incident
Name of the representative of the deceased's estate*
Full Name
Email of the representative of the deceased's estate*
example@example.com
Phone number of the representative of the deceased's estate*

Country codePhone Number
Date of death*

DayMonthYear
Street*
Street number*
Postal code*
City*
Country of death?*
Cause of death
Death caused by an ...*

AccidentIllness
Accident
When did the accident take place?*

DayMonthYear
How did the accident happened?*
Where did the accident took place?
Street*
Street number*
Postal code*
City*
Illness
When did the illness occurred?*

DayMonthYear
Which symptoms / diagnosis?*
Please upload the necessary documents
Death certificate*

Cancelof
Document showing cause of death*

Cancelof
Police report in case of accident etc.*

Cancelof
Medical report from a hospital or other health authority*

Cancelof
Power of attorney to represent the estate*

Cancelof
Certificate from the probate court*

Cancelof

Temporary total disability
Temporary total disability & Critical illness
Disability caused by an ...*

AccidentIllness
Accident
When did the accident take place?*

DayMonthYear
How did the accident happened?*
Where did the accident took place?
Street*
Street number*
Postal code*
City*
Country*
Illness
When did the illness occur?*

DayMonthYear
Date
First day of sick leave?*

DayMonthYear
Date
Last day of sick leave if you are no longer on sick leave?

DayMonthYear
Date
Which symptoms / diagnosis?*
Country where the incident took place*
Treatment
When did you seek treatment for the first time?*

DayMonthYear
Date
Name of the doctor, facility or hospital?*
Name
Street*
Street number*
Postal code*
City*
Country*
Do you have another doctor?*

YesNo
Name of the doctor, facility or hospital?*
Name
Street*
Street number*
Postal code*
City*
Country*
Do you have another doctor?*

YesNo
Name of the doctor, facility or hospital?*
Name
Street*
Street number*
Postal code*
City*
Country*
Please upload the necessary documents
All medical reports with diagnosis*

Cancelof
Employment contract*

Cancelof
Documentation for payment of unemployment benefits*

Cancelof
Medical certificate completed by own doctor in country of residence*

Cancelof
Other medical reports from a hospital or other health authority*

Cancelof

Bank details
Bank information*
Bankkonto inkl clearing*
Bankgiro*
Plusgiro*
IBAN*
BIC/Swift*
Registration number*
Account number*
Account number*
IBAN*
IBAN*
BIC/SWIFT*
payment.accountNumber*
claimant_iban*

Consent to the processing of sensitive personal data.
Denmark & Norway
I confirm that the information in this claim is correct and complete. In connection with this claim, I authorise AIG to obtain any information that AIG may deem necessary for the processing of the case, e.g. from doctors, health services, authorities or persons who process information about me and my health conditions.
By providing your personal information to AIG in connection with your claim, you consent to the collection and processing of your personal information as described in the Personal Information Use Policy available at www.aig.com/privacy-policy or upon request. Furthermore, You consent to the Policyholder confirming to AIG that You are indeed covered under the Policy. To the extent that you have provided (or will provide) personal information to AIG about third parties, you confirm that you have informed the third party of the contents of AIG's Personal Information Use Policy and you are authorized to disclose the third party's personal information to AIG as described in the Personal Information Use Policy.

Moreover, Qover, who is an independent data controller, will collect and process your personal data in connection with you reporting a claim through the insurance. You can find more information about how Qover processes your personal data by vising their Privacy Policy.
Sweden
To provide our products and services and to operate our business, we (AIG) will collect, use and disclose your personal data. We do this for various purposes, including to make automated and non-automated decisions (including profiling) about whether to provide insurance, assistance or other services, to respond to your requests, and to process claims. We may also use your personal data to detect, prevent and investigate crime (including fraud and money laundering). We may share your personal data with our partners, service providers and other third parties for these purposes. Your personal data may be transferred outside the country where you are located, including to countries outside the European Economic Area. As a data subject, you have certain rights regarding your personal data. More information about AIG's use of personal data and your rights as a data subject can be found at http://www.aig.se/integritetspolicy.

Moreover, Qover, who is an independent data controller, will collect and process your personal data in connection with you reporting a claim through the insurance. You can find more information about how Qover processes your personal data by vising their Privacy Policy.
I consent to the use of sensitive special categories of personal data relating to my health by AIG Europe S.A. i.e. the data controller and all other key data controllers, their affiliates, reinsurance companies, anti-fraud bodies and third party service providers.
When we refer to "insurance administration", we mean the work of arranging, reinsuring and administering insurance and reinsurance policies, providing ancillary services and administering claims under such policies, as well as exercising rights or complying with obligations in relation to such policies. This may include statutory rights or obligations applicable to us.

If you do not give your consent or withdraw your consent, we may not be able to deliver our services to you or manage your claim.

You have the right to withdraw your consent at any time by contacting us: AIG Claims Department, Box 3506, 103 69 Stockholm or claims.sweden@aig.com.
I authorize AIG Europe (AIG) to obtain from a doctor, health care institution, public insurance fund, the Swedish Tax Agency or other authorities and insurance companies any information that may be necessary for the assessment of my claims and insurance administration. The authorization also includes the right to inspect medical records, medical certificates and registration documents relating to my sick leave conditions. I agree that the above-mentioned documents may be disclosed to AIG. The authorization also includes the right for AIG to disclose information to the Swedish Tax Agency, other authorities and other insurance companies.
I certify that the information provided is correct and truthful.
Finland
In order to provide our products and services and to conduct our business, we (AIG) collect, use and disclose your personal information. We do this for a variety of purposes, including making decisions about whether to provide insurance, support and other services, responding to your requests and processing claims. We may also use your personal information to detect, prevent and investigate crime (including fraud and money laundering). For these purposes, we may share your personal information with our affiliates, service providers and other third parties. Your personal data may be transferred outside your country of residence, including to countries outside the European Economic Area. As a registered user, you have certain rights concerning your personal data. For more information about AIG's use of your personal data and your rights as a data subject, please visit https://www.aig.fi/henkilotietojen-suojaperiaatteet.

Moreover, Qover, who is an independent data controller, will collect and process your personal data in connection with you reporting a claim through the insurance. You can find more information about how Qover processes your personal data by vising their Privacy Policy.
I consent to the use of my personal data by the controller of AIG Europe S.A. and [its/their] affiliates, reinsurers, anti-fraud agencies and third party service providers for the purposes of administering the policy. We may also disclose information about your claim to another insurer if necessary.
When we refer to "insurance administration", we mean arranging, issuing and administering insurance and reinsurance policies, providing additional services and managing claims under those policies, including exercising rights or fulfilling obligations under those policies. This may include rights and obligations under the laws that apply to us.
If you do not give your consent or withdraw your consent, we may not be able to provide our services or deal with your claim.

You have the right to withdraw your consent at any time. If you wish to withdraw your consent, please contact AIG, Kasarmikatu 44, 00130 Helsinki, Finland.
Should be Empty:

Claim Type

Claimant information

Information about the deceased

Address of the Claimant

Involuntary loss of employment

Please upload the necessary documents

Death

Information relating to the incident

Cause of death

Accident

Where did the accident took place?

Illness

Please upload the necessary documents

Temporary total disability

Temporary total disability & Critical illness

Accident

Where did the accident took place?

Illness

Treatment

Please upload the necessary documents

Bank details

Consent to the processing of sensitive personal data.

Denmark & Norway

Sweden

Finland