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American express insurance nomination form

American express insurance nomination form 2025

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The document is an Insurance Nomination Form for American Express Cardmembers, intended to assign a beneficiary for Accident Insurance provided by ICICI Lombard General Insurance Company. It includes sections for the cardmember's details, beneficiary information, and witness signatures, emphasizing the importance of nominating a beneficiary in case of the cardmember's death.

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Click ‘Get Form’ to open the American Express Insurance Nomination Form in our platform's editor.
Begin by entering your name in the 'Name of Cardmember' field. This identifies you as the policyholder.
In the 'Beneficiary Information' section, nominate a beneficiary by filling in their name and relationship to you. Ensure accuracy for proper processing.
Provide the beneficiary's address and date of birth in the designated fields to complete their information.
Sign the form where indicated, ensuring your signature matches your name as it appears above.
Include a witness signature along with their name and address, which is required for validation.
Finally, review all entries for completeness and accuracy before detaching and returning the form to ICICI Lombard General Insurance Company Ltd.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the benefits of AmEx protection?

Purchase Protection is an embedded benefit of your Card Membership and requires no enrollment. It can help protect Covered Purchases made on your Eligible Card when theyre accidentally damaged, stolen, or lost, for up to 90 days from the Covered Purchase date. Coverage Limits Apply.

Does AmEx automatically give you travel insurance?

You can get AmEx travel insurance via your card or as a standalone policy. AmEx cards typically include coverage for trip delays, interruptions, cancellations, baggage and car rentals. Coverage tends to be secondary. Policies vary by card.

How much does AmEx insurance cost?

There is no additional charge, fee or premium payable for the insurance benefits provided with your Card. American Express does not act as an agent or fiduciary for you, and may act on behalf of the insurance provider (as its agent or otherwise), as permitted by law.

How to claim insurance with AmEx?

How Do I File a Claim? You can file your claim online or by giving us a call at 1-800-228-6855; if international, call collect at 1-303-273-6498. You will be asked certain questions about your claim at that time.

What are American Express insurance benefits?

American Express only offer Medical Assistance and Expenses, Cancelling, Postponing and Abandoning Your Trip, Cutting Short Your Trip, Personal Belongings, Money and Travel Documents and Legal Assistance and Compensation (pursuit) insurance underwritten by Inter Partner Assistance.

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Does AmEx provide health insurance?

American Express Medical Protector provides flexible medical insurance to support you when unexpected medical situations happen in your life.

Does American Express provide travelers insurance?

Amex Travel Insurance provides flexible coverage to fit your travel plans and budget.