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Liability claim

Claim application
for liability insurance

Report a claim | Liability insurance | If Insurance

Who is reporting?

Required

Only latin characters allowed

Required

Only latin characters allowed

Required

Required

Check the phone number

Required

Check the e-mail address

I do not have e-mail address

Required

Required

Claim applicant

Required

Required

Required

Required

Check the phone number

Required

Check the e-mail address

Required

Property owner

I don't know owner name

Required

Required

Name {{ model.submitter.name }}

Surname {{ model.submitter.surname }}

ID code {{ model.submitter.code }}

Phone number {{ model.submitter.phoneNumber }}

Email {{ model.submitter.email }}

Name {{ model.submitter.name }}

Company reg. code {{ model.submitter.code }}

Claim applicant

Name {{ model.submitter.contact.name }}

Surname {{ model.submitter.contact.surname }}

ID code {{ model.submitter.contact.code }}

Phone number {{ model.submitter.contact.phoneNumber }}

Email {{ model.submitter.contact.email }}

You are the owner? Yes No

Property owner {{ model.ownerUnknown }}

Name {{ model.owner.name }}

Surname {{ model.owner.surname }}

What happened?

Required

Date not valid

Date can not be in the future

Check the date

Correct time format is: 12:15

Time can not be in the future

Description of the accident {{ model.accidentDescription != undefined ? model.accidentDescription.length : 0 }} / 1000

Required

Required

Information about offender {{ model.offenderData != undefined ? model.offenderData.length : 0 }} / 100

Required

Location of the accident

Date and time of the accident {{model.accidentDate | hkDate }} {{model.accidentTime | hkTime }}

Description of the accident

{{ model.accidentDescription }}

Information about offender

{{ model.offenderData }}

Location of the accident

Country {{ model.accidentLocation.country }}

{{ model.accidentLocation.address.formattedAddress }}

Location description

{{ model.accidentLocation.description }}

Compensation

I request the compensation

Compensation will go to me

Required

Required

Required

Required

Required

Required

Account number is not correct

I do not know account number

Required

Required

Name {{ model.compensation.recipient.name }}

Surname {{ model.compensation.recipient.surname }}

ID code {{ model.compensation.recipient.code }}

Name {{ model.compensation.recipient.name }}

Company reg. code {{ model.compensation.recipient.code }}

Bank {{ model.compensation.bankName }}

Account number (IBAN) {{ model.compensation.bankAccountNumber }}

Additional comments

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File count limit reached. Some files has not been uploaded.
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{{ file.name }}
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Drop files here or click to upload
{{file.name}}

Privacy notice

If Insurance collects and processes personal data submitted with the claim and through the claims handling process according to the Privacy policy among other things: 1. handle the claim and decide on the insurance indemnity; 2. to request information about the claim event from state and local government and other persons; 3. to contact you.

Advantages:

  • Ninety percent of our clients evaluate our claims handling process as ‘good’ or ‘very good’.

  • In case of questions call us 24/7 by phone +372 777 1211.