Car insurance – other damage (as the damaged person)

Online communication does not substitute a written notification of damage (signature required), it only serves as information about the damage.

Warning: Do not insert any attachments into the online application.

Complete this notification and submit it electronically. You will receive a copy of the notification to the email address specified by you. All fields marked with asterix - * - are required

The insured vehicle
The notifying person
Damaged person
The insured person (from whose car insurance you claim the compensation)
Description of the event
Řidič poškozeného vozidla v době nehody
Information about the damaged property
Where can be the damaged items inspected? (Choose one of the options)
Witnesses
Notes