Report a claim - Assuria Verzekeringen

Report damage

Fill out the form below if you want to submit a claim.

What damage would you like to report to us?

Examples of business insurance: AVBB, AGAB, Transport & boat, Fraud & robbery

Date of accident *

Time of accident

Collision form *

Causer

Insurance certificate *

Car registration *

Drivers license *

Injured party

Insurance certificate *

Car registration *

Drivers license *

Photo 1 *

Add more photos?

No
Yes

Photo 1 *

Add more photos?

No
Yes