Car insurance claim form

Please fill it out accurately so we can follow up with you about your claim and request additional documentation.
Klicke oder ziehe eine Datei in diesen Bereich zum Hochladen.
The collision was not with a car (e.g., if the collision was with a bicycle), please write ‘bicycle’ in the field.
Inform the other party that we have been delegated to handle the claim and communicate on their behalf.
Full name, phone number, and email or address
Klicke oder ziehe Dateien in diesen Bereich zum Hochladen. Du kannst bis zu 10 Dateien hochladen.
Klicke oder ziehe eine Datei in diesen Bereich zum Hochladen.
In cases of overcharges, the insurer may proceed with the damage assessment further, so please do not proceed with the repair before agreeing to the estimate from the insurance company. 
For the protection of the policyholder, please provide a detailed description of the incident. We will handle the claim process on your behalf to avoid any statements that could be used against you.