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All claims for the CUMIS Travel Insurance Program are administered by Allianz Global Assistance. Please contact them directly or download the appropriate form below and mail in to the address listed below.
Important: In the event of a medical emergency, Allianz Global Assistance must be notified prior to any surgery being performed or within 24 hours of admission to a hospital. Emergency Medical Travel Assistance is available 24/7, by calling any of the following numbers:
Toll free within Canada/USA: 1-800-995-1662
Toll free International: 800-842-08420 or 00-800-842-08420 (if not available, please call collect)
Collect worldwide: 416-340-0049

Mailing Address:

Allianz Global Assistance
P.O. Box 277
Waterloo, ON, Canada N2J 4A4

Travel Claims Forms

Please note: Some of these claim forms are formatted for 8 ½ x 14 (legal) size paper. Printing on smaller paper sizes may result in formatting errors, however the forms are still valid for use as a claim form.

Hospital and Medical Claims

Alberta Residents


British Columbia Residents


Manitoba Residents


New Brunswick Residents


Newfoundland Residents

Application for Insurance Benefits

Northwest Territories/Yukon/Nunavut Residents


Nova Scotia Residents


Ontario Residents


Prince Edward Island Residents


Quebec Residents


Saskatchewan Residents


Trip Cancellation/Interruption Claims

Trip Cancellation & Interruption

Baggage Claims


Flight Accident and AD&D Claims 

Flight Accident and Accidental Death & Dismemberment

Medical Certificates

Emergency Hospital & Medical for Canadians Medical Certificate

Release of Information Forms


Note: Presenting a false claim is a fraudulent act and will be reported to the Insurance Crime Prevention Bureau.

This product is underwritten by CUMIS General Insurance Company, a member of The Co-operators group of companies, and administered by Allianz Global Assistance. Allianz Global Assistance is a registered business name of AZGA Service Canada Inc. and AZGA Insurance Agency Canada Ltd. ​