Machinery insurance claim notice

Notifier details

First name

Last name

Personal identification code issuer

Personal ID code

Personal ID code / date of birth

E-mail

Phone number

Insured event

Event date

Time

Country

Venue

Don't know the exact location of the event

Find address

Mark the exact location by clicking on the map

Venue additional information

Loss event description

Participants

Your machine details

Registration number

Mark

Model

Year

Description of damages

Additional information and confirmations

I request an indemnity for the incurred damages

Yes

Additional information

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.