Dwelling claim notice

Notifier details

First name

Last name

Country of residence

Personal ID code

Personal ID code/ date of birth

E-mail

Phone number

Policyholder's data

Company name

Registry code

E-mail

Phone number

Insured event

Accident date

Time

Country

Address

Venue additional information

Damage was caused by

Why and how did the damage occur?

0/1000

Who was notified?

Notification Date

Contact details of the notified person or authority

0/500

Loss event data

Damaged item

Property type

Purchase / Installation time

Contact details of the injured party

Description of damage

0/1000

Damage cost estimation

Add more damaged items

Indemnity

I request an indemnity for the incurred damages

Yes

Beneficiary

Bank account number

Additional information and confirmations

Additional information

0/1000

I confirm the accuracy of the above data and agree to the processing of my personal data by LHV Kindlustus in accordance with the principles of LHV customer data processing.

I know that if I knowingly submit wrong data, then insurer has the right to decrease compensation or refuse to pay compensation completely.

I agree that insurer has the right to request additional information concerning the claim from persons that possess it.

Dwelling claim notice

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