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Property Insurance claim
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Policy holder
Type of insurance
Type of insurance*
Property
Casco
Civil liability
Travel and accident
Cargo
Policy holder:*
Personal ID:*
With policy №:*
Address*
Email*
Phone*
Event type
Event type
Fire
Electric shock and indirect lightning strike
Flood
Other
Event type
Event type
Traffic accident - Report of the incident
Road accident - declaration
Damaged car found
Natural disaster
Other
Method of compensation
Method of compensation
Service
Payment by bank transfer according to expert assessment
Event type
Event type
Traffic accident with a bilateral protocol
Traffic accident with police report
Road accident with a report of findings in injured persons
Method of compensation
Method of compensation
By expert assessment
By out-of-court settlement
Event type
Event type
Medical expenses
Luggage theft
Baggage loss or delay
Flight delay of more than 5 hours
Missing a connecting flight
Shortening your stay abroad
Temporary loss of working capacity due to an accident
Permanent loss of working capacity
Death
Other
Event type
Event type
Cargo theft
Lack of load
Damage during loading and unloading
The Policy holder in the Claimant:
Owner
Assignee
Insurance broker
Lessee
Tenant
Injured person
Lawyer
Cargo owner
Event and request:
Date:*
Address of the event*
Short description of the event*
Short description of the damage*
Attached files (up to12):*
4 diagonals
Chassis (VIN number)
KM
Damaged detail - close up
Damaged detail - at an angle
2 photos from the event location
Photos of the other person involved in the accident
Real estate/Non-moving goods
4 diagonals
Chassis (VIN number)
KM
Damaged detail - close up
Damaged detail - at an angle
2 photos from the event location
Photos of the other person involved in the accident
Real estate/Non-moving goods
File to upload
Attach an image
The maximum file size is {2}MB.
Attached files (up to12):*
Attached files (up to8):*
Driving license
Vehicle registration certificate - part 2
Valid Annual Technical Inspection Certificate
Road accident report
Bilateral finding protocol
Police report
Report of the injured party
Emergency protocol
Document from a competent authority
Written protest to the guilty party
Claim for compensation
Bill of lading
Invoice and packing list of the goods
Document of an event that occurred
Medical documents /epicrises, outpatient lists, etc./
File to upload
Attach a document
The maximum file size is {2}MB.
Attached files (up to8):*
I declare that for the damages sustained:*
I have not received compensation;
have received a compensation
From:*
Amounting to BGN:*
I declare that for the damaged property:*
I don’t have a valid policy with another insurer
I have a valid insurance
With (company):*
With policy №:*
Bank information of the insured person:
Names of the insurance holder*
IBAN:*
||||||||||||||||||||||
Confirmation:
I confirm the authenticity of the data and documents I have provided.
Приемам и се съгласявам, че при предявяване на застрахователна претенция чрез онлайн портала на „ЗД ЕВРОИНС“ АД и за целите на онлайн предявяването на застрахователната ми претенция, поставянето на отметки на предвидените за това места, натискането на бутон за преминаване на следващ прозорец и попълването на данни, съставляват подписване от моя страна с електронен/усъвършенстван електронен подпис, който в отношенията ми със „ЗД ЕВРОИНС“ АД по повод предявяването на претенцията ми, ще се ползва със силата на собственоръчно поставен от мен подпис. Приемам и се съгласявам, че при предявяване на застрахователна претенция чрез онлайн портала на „ЗД ЕВРОИНС“ АД и за целите на онлайн предявяването на застрахователната ми претенция, попълнените от мен данни, заявки, декларации и документи, съставляват електронни документи и съдържат електронни изявления по смисъла на Закона за електронния документ и електронните удостоверителни услуги и имат силата на оригинален документ, подписан собственоръчно от мен. Приемам и се съгласявам, че всяко поставяне на отметка, натискане на бутон за преминаване на следващ прозорец и всяко попълване на данни, представлява отделно електронно изявление.
I am aware that the insurer has the right, within 45 days from the date of filing a claim, to request additional documents and information, pursuant to Art. 106 and Art. 107 of the Civil Code, to determine the grounds for payment and the amount of the insurance compensation.
I have checked and agree that the insurance compensation will be paid to the bank account I have indicated.
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