Telesales Customer Files Upload

Step 1

Download Forms

Insurance Application Form 1 MB

Summary of Health Insurance Coverage 304 KB

Marketing Consent 272 KB

Upon forms downloaded, please fill out the forms thoroughly and return them to the company with details below.

Step 2

Fill in the information below and return all the forms/documents to the company

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Name

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Family Name

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Contact number

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Please enter a phone number with 10 digits (such as 0811234567)

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Upload document files and return them to the company with details below.

1. Insurance Application Form*

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2. Summary of Health Insurance Coverage*

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3. Marketing Consent*

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4. Copy of ID/Passport*

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5. A selfie of applicant along with holding national ID*

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6. A copy of birth certificate for a child*

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7. A copy of book bank for Claim Payment*

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Note:

*Allianz Ayudhya Insurance Company reserves the right to request original documents
*File Transfer 4 MB per file.
*File Transfer in format .jpg, .png, .pdf, .doc, .xlsx, .pptx

“I here by give my consent to collect, use and disclose my personal data for the purpose of advertising, conducting marketing analysis, proposing and offering about products, services and other privilege programs provided by the Company, companies in Allianz Group, or the Company’s contracting parties, and for other purposes as specified in the” Privacy Notice

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