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phone1900 633 369
Tiếng Việt
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Claim request
Claim request
New contract
New contract
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Contract amendment
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Authorization

New contract

Please select the appropriate form, fill fully information and submit to Aviva Vietnam by one of the following methods:

    account_balanceSubmit your request directly at the office or the nearest branch office of Aviva Vietnam.

    supervisor_account Submit via servicing agent insurance

    email Submit a request to Vietnam Post (VN Post) at 13th floor, Mipex Tower, 229 Tay Son, Dong Da district, Hanoi.

New contract
Number Documents Download
1

The Declaration of organization information and list of insurance buyers

cloud_download
2

Extension Request

cloud_download
3

Financial Questionnaire (2 page)

cloud_download
4

Nationality and permanent address declaration form (for Multiple citizenship person)

cloud_download
5

Health Questionaire

cloud_download
6

Agent report

cloud_download
7

DOB delaration

cloud_download
8

ACK reprint request

cloud_download
9

Certificate reprint request

cloud_download
10

Cancellation request

cloud_download
11

Medical Result Request

cloud_download
12

Parental Consent

cloud_download
13

Application Form for Corporate

cloud_download
14

Guarantee Form in case of Expired ID

cloud_download
15

Assignment Form (for Assignee of Children Medical Check Accompanion)

cloud_download
16

FATCA Form

cloud_download
17

Supplementary Statement

cloud_download
18

Signature Confirmation

cloud_download
19

High blood pressure

cloud_download
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Consultant

Headquarters

AVIVA VIETNAM
LIFE INSURANCE COMPANY LIMITED

13th floor, Mipec Tower, 229 Tay Son, Dong Da District, Hanoi

Contact center: 1900-633-369
Tel: (84) 24 3771 5577
Fax: (84) 24 3724 6446
Email: wecare@aviva.com.vn


Business license No. 64 GP/KDBH enforced 29/07/2011


Branch office

AVIVA VIETNAM
LIFE INSURANCE COMPANY LIMITED

8th floor, Mapletree Business Centre, 1060 Nguyen Van Linh Street, Tan Phong Ward, District 7, Ho Chi Minh City

Contact center: 1900-633-369
Tel: (84) 24 3771 5577
Fax: (84) 24 3724 6446
Email: wecare@aviva.com.vn
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