Insurance case

Please fill in the data carefully

Individual Legal entity

IIN *

Enter the IIN!

Full name *

Enter your full name!

Insurance contract/Insurance policy *

Enter the Insurance Contract/Insurance policy!

Event date *

Enter the Date of the event in the correct format!

Detailed description of the event *

Enter the Description of the event!

Approximate amount of damage/claim *

Enter the Amount of damage/claim!

Contact phone number of the applicant *

Enter your Contact phone number!

Applicant's home address *

Enter your Home address!

Applicant's email address *

Enter your Email address!

Documents and photos of the insurance event

Upload photos of the document Upload or drag photos of the document
(formats .jpg,. png or .pdf not exceeding 9.54 MB.)