Notification of the damage event caused to health

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

Insured person
Fill in if you have arranged seat accident insurance

Please provide information about every transported person

Person #1
Person #2
Description of the event
Fill out in case of any personal accident insurance claims
Fill out in case of supplementary insurance claims for medical activities not covered by the general health insurance
Investigation of the event