Online Claims

Submit your personal accident claim information online

At FPG Insurance, we’ve made it very easy for you to submit your personal accident claim online. Simply complete the following form and attach the relevant documents. We will then review your claim and if needed, a personal accident claim representative will contact you directly to confirm your claim details and request any additional information.

Need help with your claim? Call us at +62 (21) 5082 1555 Monday to Friday 8.30am - 6.00pm

Claimant Information

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Employment Information
Accident Information

Doctor & Hospital Information

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Confinement Information

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