Eurobank Cyprus

Submit a claim

Dear Customers if you wish to submit a claim in respect to the Travel Insurance, please fill out the “Notice of Claim Form” Pdf link within 25 days of the incident. Please send the form directly to the email: office@genassist.eu or fax to +357 22 499 830.

Disclaimer

You acknowledge the fact that Eurobank Cyprus (the Bank) will not have any access or will not process any data disclosed to the Gen Assist TPA within the claim form. The Bank does not assume any liability or responsibility in relation to a claim and/or completion of the claim form and/or provision of personal data.

By submitting the form, you agree with the Privacy Notice section of the form.

For further information please contact GenAssist TPA at +357 22 519 211.

Travel Insurance - Visa Classic Debit - View pdf

Travel Insurance - Visa Gold - View pdf

Travel Insurance Policy - View pdf

Please let us know about you

Title:

First Name: * as it appears on your National ID:

Last Name: * as it appears on your National ID:

Father's Name: * as it appears on your National ID:

Citizenship:

Cyprus National Identification Number:

Email Address:

Mobile Phone:

Date of Issue:

Date of Expiry:

Tell us more about you

Some additional details about you

Gender:

Date of Birth:

Place of Birth:

Country of Birth:

Marital Status:

Nr of Dependants:

Education Level:

Correspondence Language:

Business Profile

Tell us what you do for a living

Employment Status:

Country of Tax Residense:

Profession:

Former Profession:

Annual Gross Income (€):

Residential Address Details

Please enter details to communicate with you

Google Address:

Address Street & Number:

Postal Code:

Area/District:

City:

Country:

Product and Services

Are you an existing eBanking User?:

What is your eBanking User ID?:

*The account requested through this application will be linked to this ebanking User ID

Connect a Debit Card with the account?:

Full Name to be Printed on the Card :

* Please use Latin and Capital - maximum up to 26 characters

View and Manage your account via Internet Banking:

Receive your account statement electronically?:

Preferred Banking Center

Select the Banking Center most convenient to you

Banking Center Location:

*Select the Banking Center location most convenient to you

Document Attachments

Please attach the supporting documents

*If you are having trouble uploading the necessary documents, please contact us for assistance

Proof of Identification:

*Only .pdf files are accepted

Proof of Identification 2:

*Only .pdf files are accepted

Proof of Address :

*Recent Utility Bill (not older than 6 months) - only PDF files are accepted

Proof of Income:

e.g. payslip - only PDF files are accepted

Aknowledgement

I confirm, agree, declare and assume under penalty of perjury or fraud, that I have read, understood and accept the General Terms , the Privacy Notice and the Declaration for my account opening request, and that the information given in this application form to Eurobank Cyprus Ltd (the “Bank”) is true, accurate and complete:

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