Download Forms | Allianz Ayudhya

อลิอันซ์ อยุธยา Allianz Ayudhya - service-download

Service & Contacts

We value personal contact with you as one stop service. Please select from the following list of contacts, so we can help you further:

Call 1373 (24Hours)

Online EnquiryEmail

As added convenience for our customers, you can download forms online for many purposes such as claim forms, forms for special privileges and many other forms for use by ordinary life and group life insurance customers.

General Download

Whether you are an in-patient or an out-patient, Allianz Ayudhya customers can be confident that they will receive the best service at all of our AyudhyaCare Network hospitals. This reflects not only our determination for your utmost satisfaction, but also that Allianz Ayudhya is committed to service excellence for every rhythm of your life.

 Letter of Consent - Disclose personal information of the Insured

Direct Debit and Direct Credit request form

OPD Claim Form

AI/IPD/PA/CI Claim Form

Payment Form (This form only available in Thai)

New cheque Issuance Request Form

Death Claim Form

TPD Claim Form

Complaint Receipt Form (This form only available in Thai)

Download for Group Insurance

Appoint Policyholder to be Beneficiary Form

Employee Benefits Manual

Agreement on the use of Group Insurance ID Cards

AI/IPD/PA/ CI Claim Form

Download for Group Personal Accident

Enrollment Request Listing Form for Group Life Insurance (New Business)
(Download Exel File Click..)

Group Personal Accident Application Form (Policy holder)

OPD Claim Form

 AI/IPD/PA/CI Claim Form

Death Claim Form

Download the questionnaire from the underwriting department

Letter to express your intent to buy My First Class @BDMS and to cancel MHP MHPE

Download FATCA Forms

อลิอันซ์ อยุธยา Allianz Ayudhya - bns-registered