Report a property damage

Basic information about the damage

Damaged were ... (select one option) *


Damaged things

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Damaged rooms

Add more rooms

Cause of the damage * (select one option)

Estimated damage in CZK * (select one option)

Information about the insured person

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Summary

Basic information about damege

Damaged were

Household / sublet

Insurance policy no.

Place of damage

Date and time of damage

Account number


Description of the damage

Damaged things

Name

Cost

CZK

Age

years

months

Name

Cost

CZK

Age

years

months

Damaged rooms

Living room

Length:  cm

Width:  cm

Height:  cm

Kitchen

Length:  cm

Width:  cm

Height:  cm

Bathroom

Length:  cm

Width:  cm

Height:  cm

WC

Length:  cm

Width:  cm

Height:  cm

Kids room

Length:  cm

Width:  cm

Height:  cm

Bedroom

Length:  cm

Width:  cm

Height:  cm

Lobby

Length:  cm

Width:  cm

Height:  cm

Hall

Length:  cm

Width:  cm

Height:  cm

Chamber

Length:  cm

Width:  cm

Height:  cm

Length:  cm

Width:  cm

Height:  cm

Length:  cm

Width:  cm

Height:  cm

Cause of the damage

Rain

Details of damage

Estimated damage in CZK

To 30 000 CZK


Information about the insured person

Name and surname

Date of birth

Tel. no.

E-mail


Photos

Damage

Documents

Thank you

Thank you

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