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Japan Host Insurance Intake Form
You must accept the terms and conditions by clicking the checkbox and signing in the box below to proceed.
All fields marked with * are required
Host Account Name
Guest Account Name
Phone Number(as registered on Airbnb)
Invalid phone number
Email(as registered on Airbnb)
Are you aware of any existing insurance coverage for this incident?
Date of Incident
Country/Region of Incident
State of Incident
Property Damage and Bodily Injury
Incident Description (maximum 1000 characters)
By checking this box, I agree to the Airbnb Japan Host Insurance Program
", and confirm that all the information that I have submitted is true and correct. I also give my consent that the signature input below is considered as my own hand-written signature.