Notification of claim
Interfaces
Vehicle card scan
Policyholder
Salutation
Mr.
Mrs.
Company name
Name *
First name *
Street
Zip * / Location *
Mobile phone *
Email *
The mobile number and email address will be used for further communication with you.
Vehicle
Brand *
Type *
License plate *
Kilometer total
Damage
Damage date *
Damage location *
Remarks
* = mandatory field
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