Report defendant car

Report the sale or purchase of a vehicle
Change policy data
Policy termination
Contact form

Insurance details

Policy series and number *

Notifier’s data

Personal code *

Name

Surname

Telephone *

E-mail *

Give us your email so we can send you a confirmation of filing your case

Type of inquiry

Type your notification *

Add Attatchment

Upload document

Read the Information Clause before submitting the form.

I consent to the transfer of documents and information related to the execution of the application by means of electronic communication, including telephone and e-mail.

I declare that the data I have provided are true.

Clear form

Insurance details Please write Policy number

Notifier’s data

Type of inquiry

Add Attatchment

Subscribe for newsletter!

Insurance details