MTPL insurance | File a claim

Motor Third Party
Liability Insurance

Event report by liable party

Information about accident

Event date*

Event time

Event country

Event address ( address, city or GPS)*

How did the accident happen (detailed in chronological order)? *

Write text here…

INFORMATION ABOUT INSURED VEHICLE

Vehicle registration number

Trailer registration number

Driver at the time of the accident

Name**

Surname**

Personal/company code*

INFORMATION ABOUT THIRD PARTY

Vehicle registration number/Property name

Was anyone injured?

Information about the other victim of the traffic accident

Was anyone injured?

Attach available documents

Accident agreement/ Police report

This doesn't matter

Vehicle registration certificate

This doesn't matter

Driving licence

This doesn't matter

Vehicle damage photos

This doesn't matter

Photo from event place

This doesn't matter

DETAILS OF THE NOTIFIER

Notifier is the policyholder

Name

Surname*

Personal identification number/ Date of birth*

Address*

Phone number*

E-mail*

Select all

I confirm I have read the Privacy Policy, the information I have provided is correct and I am fully authorized to submit this claim application and, upon request of Balcia, I will provide other necessary data and documents. I am aware of and agree on the mutual communication (including document submission) via email.

I agree to receive information about promotions, discounts, bonuses and other marketing activities, including requests for my opinion about Balcia services. Choose

Motor Third PartyLiability Insurance

Information about accident

INFORMATION ABOUT INSURED VEHICLE

INFORMATION ABOUT THIRD PARTY

Information about the other victim of the traffic accident

Attach available documents

DETAILS OF THE NOTIFIER

Subscribe for newsletter!

Motor Third Party
Liability Insurance