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Report an insurance claim

Report an insurance claim online

Policyholder

Injured party

If known
Only complete in the case of property damage
The policyholder is obliged to fill in this form completely and truthfully and to return it without delay. The policyholder is not entitled to acknowledge or satisfy the liability claim in whole or in part without the express consent of the company (compare § 5 of the General Insurance Conditions for Liability Insurance).

The case law of the Federal Supreme Court (BGH) prompts us to make the precautionary remark that
deliberately untrue or incomplete information can lead to the loss of insurance cover even if this information had no influence on the determination of the insured event or on the determination or scope of the insurance benefit.
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