Motor Third Party
Liability Insurance

Third party notification of the event

EVENT INFORMATION

How did the accident happen(detailed in chronological order)? * Example
Chronologically describe what happened, include other participant, weather etc. Describe the damage in details. If the police was notified, tell us what was the result of intervention. Ad inform us if perpetrator fled the scene or wasn’t authorized to drive.*

INFORMATION ABOUT LIABLE VEHICLE

Is driver the policyholder?


INFORMATION ABOUT THIRD PARTY

Driver at the time of the accident:

SUPPORTING DOCUMENTS ( PROVIDE AVAILABLE ACCORDING TO THE LIST)

The size of a single attached document should not exceed 5MB, and the maximum size of all documents should not exceed 30MB. Allowed file types: pdf, jpg, doc, xls, rar, zip, 7z, bmp, png.


PLEASE CHOOSE THE METHOD OF COMPENSATION:


Read the Information Clause before submitting the form.

* - Mandatory fields