Claim your damages – Property damage & business interruption insurance

* Required fields are marked with an asterisk.

Personal data

Insured party / Insured person*: Number of insurance policy*:

Information about the insured event

Insured event*:
Date of Insured Event*: Time of Insured Event*: Address (location of Insured Event)*: Has the damage been reported to the police?*
Yes No
Detailed description of the event*: A short list of damaged property and/or loss: Do you expect an interruption of work due to damage/incurred loss?*
Yes No
Approximate non-binding total damage estimation (EUR):

Data for insurance claims payment

IBAN: Account owner’s name:

Please provide the documentation

Possible documentation to attach depending on the type of insured event:

Damage photos
Service contractor’s offer or invoice
Police report or Record of another competent authority
Service contractor’s report
Internal records
List of damaged and/or destroyed property with value
Calculation elements for work interuption claims
Review of damages and claims
Other

* The maximum allowed attachment size is 75 MB.

Documents

+ Choose files

Final provisions

E-mail address for further contact:
Contact information for possible damage inspection at the location (including phone number)*:
Consent*

By submitting the claim the client gives his/her consent to Brokko to use his/her personal data, as well as all other data that Brokko comes in contact with when providing insurance brokerage services, for the purpose of resolving compensation claims addressed to the insurance company as well as use such data in its business records and process them in compliance with positive law and legal regulations.

Agree

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