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Insurance Claim Form (UAE)

Insurance Claim Form (UAE)

INSURANCE CLAIM FORM

Date of Submission: [Claim Date]

POLICYHOLDER DETAILS

Name: [Policyholder Name]

Emirates ID: [Emirates ID]

Telephone: [Phone Number]

Email: [Email Address]

POLICY DETAILS

Insurance Company: [Insurer Name]

Policy Number: [Policy Number]

Policy Type: [Policy Type]

Policy Period: [Policy Start Date] to [Policy End Date]

INCIDENT DETAILS

Date of Incident: [Incident Date]

Location of Incident: [Incident Location]

Description: [Incident Description]

Police Report Reference: [Police Report Number]

CLAIM DETAILS

Total Amount Claimed: [Claim Amount]

Particulars of Claim: [Claim Description]

Documents Attached: [Supporting Documents]

DECLARATION

The undersigned declares that the information given in this form is true and complete to the best of the claimant's knowledge and belief, and that all losses claimed arose from the incident described above. The claimant acknowledges that providing false or misleading information to an insurer is an offence under the UAE Insurance Law (Federal Decree-Law No. 48 of 2023) and may result in cancellation of the policy and referral to the Insurance Authority and, where relevant, the public prosecution.

Signature: ______________________

Name: [Policyholder Name]

Date: [Claim Date]

Claimant / Policyholder

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Insurance Claim Form (UAE)?

An Insurance Claim Form in the UAE is the formal written submission through which a policyholder notifies an insurer of a loss, damage, or liability event and requests payment of the insured benefit, operating under the Insurance Law — Federal Decree-Law No. 48 of 2023, which is the primary legislation governing insurance contracts, insurers, and policyholders across the United Arab Emirates. The form captures the policyholder's identity, Emirates ID number, policy reference, the nature of the insured event, the date and location of the incident, and the monetary quantum of the claim, providing the insurer with the information it requires to assess, investigate, and settle the claim in compliance with the Central Bank of the UAE's regulatory instructions.

Insurance in the UAE covers a wide spectrum of risks. Motor insurance, whether compulsory third-party liability under Cabinet Resolution No. 25 of 2009 or complete cover, is the most frequently claimed line. Health insurance, mandatory in Dubai under Law No. 11 of 2013 administered by the Dubai Health Authority (DHA) and in Abu Dhabi under regulations of the Department of Health (DOH), generates high volumes of medical expense and hospitalisation claims. Property insurance protects buildings and contents against fire, flood, theft, and accidental damage, and is increasingly required by mortgage lenders such as banks regulated by the Central Bank of the UAE as a condition of home finance. Liability insurance covers third-party bodily injury and property damage arising from business operations, professional services, and public activities. Travel insurance covers trip cancellation, baggage loss, and emergency medical costs for UAE residents travelling abroad.

The general contractual framework for insurance policies is supplied by the UAE Civil Code (Federal Law No. 5 of 1985), which governs the formation, interpretation, and breach of contracts. Article 1028 of the Civil Code defines insurance as a contract by which the insurer undertakes, against payment of a premium, to pay compensation or a sum of money to the insured or beneficiary upon the occurrence of the agreed event. The duty of disclosure, which requires the policyholder to accurately declare material facts at the time of taking out the policy, flows from the Civil Code's good-faith obligations and is specifically reinforced in Federal Decree-Law No. 48 of 2023. Breach of the duty of disclosure may entitle the insurer to avoid the policy or reduce the claim.

The Insurance Authority of the UAE, whose regulatory functions were merged into the Central Bank of the UAE following Cabinet Resolution No. 24 of 2020, licenses and supervises insurance companies, brokers, agents, actuaries, and loss adjusters operating in the UAE. The Insurance Complaints Unit of the Central Bank of the UAE receives and mediates disputes between policyholders and licensed insurers at no charge. Claims that cannot be resolved through the insurer's internal complaints process or the Central Bank's unit may be litigated before the Dubai Courts, the Abu Dhabi Judicial Department, or, where parties have chosen those forums, the DIFC Courts or ADGM Courts.

Using a well-structured Insurance Claim Form, such as the template available on forms-legal.com, ensures that all required fields are completed consistently, that the policyholder's declaration is recorded, and that the document is ready for submission to any licensed insurer in the UAE. Accurate and complete documentation at first submission reduces delays and minimises the risk of a claim being declined on procedural grounds.

When Do You Need a Insurance Claim Form (UAE)?

An Insurance Claim Form is needed in the UAE whenever a policyholder experiences an insured loss and wishes to seek indemnity or a benefit payment from the insurer. The most common triggers are motor accidents, which in Dubai and other emirates require both a Dubai Police or Abu Dhabi Police accident report and a formal claim submitted to the motor insurer within the notification period specified in the policy — typically 14 to 30 days from the incident.

Health and medical claims arise after hospitalisation, surgery, specialist consultations, or pharmaceutical purchases covered under the health policy. In Dubai, facilities registered with the Dubai Health Authority issue standardised medical reports and invoices that insurers accept. In Abu Dhabi, the Department of Health registration of the treating facility is equally important. Claims submitted outside the network of approved providers or without prior authorisation, where that authorisation is required by the policy, may be partially or fully declined, so policyholders should check the terms before receiving treatment whenever possible.

Property claims arise after fire, water damage, burglary, or vandalism affecting a home or commercial premises. Where a crime is involved, the relevant emirate police authority must be notified and a police report obtained before the claim is filed. Policyholders who hold Ejari-registered residential tenancies in Dubai should confirm whether their landlord's building insurance extends to contents or whether a separate contents policy is needed. Title deeds from the Dubai Land Department are useful supporting documents for property ownership claims.

Travel insurance claims are filed for trip cancellations, missed connections, lost baggage, and emergency medical costs incurred abroad. The claim form and supporting documentation — airline cancellation notices, medical reports from the overseas treating facility, baggage irregularity reports from the carrier — must typically be submitted within 30 to 90 days of return to the UAE. Life insurance and personal accident claims, including death benefits and permanent disability payments, follow different procedures and may require additional documentation including death certificates and medical assessments by the insurer's approved physicians.

Business interruption, cyber, professional indemnity, and engineering claims require specialist assessment and often involve loss adjusters appointed by the insurer. In all cases, submitting the claim form promptly after the loss event and retaining copies of all supporting documents is the practical foundation of a successful claim under Federal Decree-Law No. 48 of 2023.

What to Include in Your Insurance Claim Form (UAE)

A UAE Insurance Claim Form must contain several essential components to be accepted and processed by a licensed insurer under Federal Decree-Law No. 48 of 2023. The first element is accurate policyholder identification: the full legal name matching the Emirates ID, the Emirates ID number (in the 784-YYYY-XXXXXXX-C format), contact telephone, and email address. Where the claimant is different from the policyholder — for example a beneficiary claiming a life benefit — both identities must be recorded and the claimant's authority to claim must be established, whether through a power of attorney drawn under UAE law or a beneficiary designation.

The policy reference section must state the insurer's full name as licensed by the Central Bank of the UAE, the policy number, the type of cover, and the policy period. Confirming that the loss occurred during the policy period is a threshold condition: a claim for an event outside the policy dates will be declined regardless of merits. Where the policy is a group scheme, for example an employer-provided health plan or a UAE company motor fleet policy, the certificate or the employee's enrolment reference should also be noted.

The incident narrative must record the date, time, and precise location — the emirate, street name, or area. For motor claims, the location reference used in the traffic accident police report is the most reliable description. The description of the incident should be factual and accurate, identifying all parties, vehicles, property, and individuals involved, consistent with the police report where one exists, since discrepancies between the claim form and the police report give insurers grounds to investigate further. The police report case number issued by Dubai Police, Abu Dhabi Police, or another emirates authority should be recorded where available.

The claim quantum section should itemise each head of loss separately: vehicle repair, rental car, medical expenses, personal property, third-party damage, or business interruption, each supported by invoices, quotes, or medical reports. Specifying amounts in AED, the currency of UAE insurance policies, avoids ambiguity. The total claimed should match the sum of the itemised amounts, since unexplained discrepancies are a common reason for follow-up queries.

The supporting documents checklist confirms what evidence is attached. Submitting the police report, Emirates ID, photographs, and the repair estimate in a single complete package using the forms-legal.com template reduces insurer queries. The declaration at the foot of the form, signed by the policyholder, attests to the accuracy of the information and acknowledges the consequences of misrepresentation under Federal Decree-Law No. 48 of 2023 and the UAE Civil Code (Federal Law No. 5 of 1985). The form date should be the actual date of submission, not a date backdated to the incident.

How to Fill Out Your Insurance Claim Form (UAE)

Filling in a UAE Insurance Claim Form correctly from the outset shortens settlement time and avoids unnecessary back-and-forth with the insurer under Federal Decree-Law No. 48 of 2023. Begin by assembling all supporting documents before opening the wizard: the Emirates ID, the insurance policy certificate or schedule, the police report if one was issued, photographs or video of the damage, and all invoices or medical reports.

In the policyholder details section, enter the full name exactly as printed on the Emirates ID — do not use nicknames or abbreviations. Enter the Emirates ID number in the standard 784-YYYY-XXXXXXX-C format. Use a contactable UAE mobile number and a regularly monitored email address, because insurers send acknowledgment and queries to these contacts.

In the policy details section, find the insurer's name on the policy schedule or the insurance certificate. Enter the policy number precisely; a single transposed digit will delay the claim while the insurer locates the correct policy. Select the policy type from the dropdown — motor, health, property, travel, life, liability, or other. Record the policy start and expiry dates from the schedule, since the insurer will verify that the incident date falls within the covered period.

For the incident section, enter the date in DD/MM/YYYY format consistent with UAE document standards. Record the location as specifically as possible: the emirate, the road or area, and any relevant identifier such as a building name or a plot number. In the description field, state what happened factually and in sequence, identifying any third parties and their contact details. Cross-check the description against the police report to ensure consistency.

In the claim section, itemise all losses separately and enter the total in AED. Tick the supporting documents checklist to confirm what is attached, and set the submission date as today's date. Review the live preview to check that all fields have populated correctly. Print, sign the declaration, and deliver the completed form together with all supporting documents to the insurer's claims department, either by hand, registered post, or through the insurer's online portal. Retain a copy with proof of receipt for your records.

Common Mistakes to Avoid in Your Insurance Claim Form (UAE)

Common mistakes when filing insurance claims in the UAE under Federal Decree-Law No. 48 of 2023 typically relate to late notification, incomplete documentation, and inconsistent descriptions. The most frequent error is delayed reporting: policyholders who wait several weeks before contacting the insurer may find that the notification period in the policy has expired, giving the insurer grounds to reduce or decline the claim. Notify the insurer as soon as possible after the loss event and confirm receipt in writing.

Submitting an incomplete claim form — missing the policy number, the Emirates ID, or an accurate incident description — is the single greatest cause of insurer follow-up queries and delayed settlements. Always assemble the complete document package before submission. Photographs taken at the scene immediately after an incident are among the most persuasive evidence in disputed motor and property claims, and the failure to document the damage contemporaneously is a mistake that cannot easily be corrected later.

Inconsistencies between the claim form and the police report are a major red flag for insurers. If the claim form describes the accident differently from the traffic police report issued by Dubai Police or Abu Dhabi Police, the insurer will query the discrepancy and may refer the matter for further investigation. Always cross-reference the claim form description against the police report before submission.

Overstating the claim amount, whether by including losses outside the policy cover, inflating repair costs beyond competitive market rates, or double-counting expenses already recovered from a third party, is a form of insurance fraud under UAE law and Federal Decree-Law No. 48 of 2023. Courts and the Central Bank of the UAE take insurance fraud seriously, and insurers maintain fraud registers shared with other industry participants. Finally, failing to retain copies of the submitted claim form and all supporting documents leaves the policyholder without proof of submission if the insurer claims non-receipt or raises a dispute later.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Insurance Claim Form (UAE) (United Arab Emirates) [Legal document template]. Forms Legal. https://forms-legal.com/uae/financial/insurance/insurance-claim-form-uae

MLA

"Insurance Claim Form (UAE) (United Arab Emirates)." Forms Legal, 2026, https://forms-legal.com/uae/financial/insurance/insurance-claim-form-uae.

BibTeX
@misc{formslegal-insurance-claim-form-uae,
  author       = {{Forms Legal}},
  title        = {Insurance Claim Form (UAE) (United Arab Emirates)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/uae/financial/insurance/insurance-claim-form-uae}},
  note         = {Free legal document template. Based on Insurance Law — Federal Decree-Law No. 48 of 2023}
}

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Frequently Asked Questions

Based on Insurance Law — Federal Decree-Law No. 48 of 2023 — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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