MTPL insurance | File a claim

Vehicle registration number/Property name

Owner's name, surname/company name *

Personal/company code*

Address*

Phone number*

E-mail*

Was anyone injured? *

Victim full name

Victim personal code

Attach available documents

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, zip, 7z, bmp, png.

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF reimbursement:

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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 have been open and truthful in providing all the necessary information. I don’t object that means of distance communication are used for mutual communication (including the transmission of documents).

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Motor Third Party
Liability Insurance

Information about accident

INFORMATION ABOUT INSURED VEHICLE

INFORMATION ABOUT THIRD PARTY

Attach available documents

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF reimbursement:

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Motor Third PartyLiability Insurance

Information about accident

INFORMATION ABOUT INSURED VEHICLE

INFORMATION ABOUT THIRD PARTY

Attach available documents

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF reimbursement:

Subscribe for newsletter!

Motor Third Party
Liability Insurance