Online damage report

Claims usually come as a surprise. What counts now is a quick response and taking the right measures.

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Company

This field is for validation purposes and should be left unchanged.

Name (Company / Organistion)*

Street/Block Number*

Number*

Post Code*

City*

Country*

First Name*

Last Name*

Mobile*

Email*

Location (of Incident)*

Incident Date

Cause of Damage (fire, water, other)*

Affected Property (building name)*

Affected Floors (list floor numbers - Ground, 1st, 2nd, etc.)*

Affected Machinery and Equipment*

Description of Incident (provide details)*

Image

Max. file size: 5 MB.

Video

Max. file size: 5 MB.

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