Claim report for forwarding insurance

For SVS, MSVS, CMR – Insurance, Subsidiary – Insurance, Additional – Cover, Combined -policy, Customs, BL –
fields marked with * are mandatory fields and must be filled in!

Policy number*

Policyholder *

E-Mail *

Phone number:

Claim number *

Pos-Nr.

Schadendatum*

When and by whom did you receive the order? *

What is the order? *

Is the client forbidden? *

JaNein

If the client is not a Prohibitor, with what sum insured was the SVS-Cover *

Name of the victim? *

Number of packages and weight? *

Healthy / commercial value of the shipment according to the invoice? *

Claim description *

What is the claim? *

Which SV has already been commissioned with the damage assessment? *

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