Claims report Engineering insurance

• 1When and where did the loss/damage occur?
• 2How did the damage occur?
• 3What damage occurred?
• 4How high do you estimate the damage?
• 5Was the damage reported to the police?
• 6If the damaged items are not at your address: Where can they be inspected?
• 7Would you like to attach documents?
• 8Are you the policyholder?
• 9What is the policy number?
• 10Policyholder
• 11What are your payment details?
• 12Would you like to notify us about something else?
• 13You have almost completed the form

When and where did the loss/damage occur?

Date

Country

How did the damage occur?

What damage occurred?

How high do you estimate the damage?

Select amount

Was the damage reported to the police?

If the damaged items are not at your address: Where can they be inspected?

Please enter a phone number in the format +41 XX XXX XX XX or +423 XXX XX XX

Would you like to attach documents?

Select a file

Are you the policyholder?

You are

Title

Please enter a phone number in the format +41 XX XXX XX XX or +423 XXX XX XX

What is the policy number?

You can find the policy number on an AXA contract or invoice (e.g. xx.xxx.xxx).

Policyholder

Title

Country

Please enter a phone number in the format +41 XX XXX XX XX or +423 XXX XX XX

Country

Contact person

Title

Please enter a phone number in the format +41 XX XXX XX XX or +423 XXX XX XX

What are your payment details?

Payment types

Are you the policyholder?

Please enter the precise account descriptions. In the case of a joint account, please enter both names.

Please note:
You can find your IBAN on account statements, notifications, and debit cards (Maestro cards and account cards). Or determine your IBAN number here.

Here you can determine the BIC number.

Please note: You can attach all open ESR invoices at the end of the claims notice.

Would you like to notify us about something else?

You have almost completed the form

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