Forwarding insurance claim form

For SVS, MSVS, coat, total policy, VS, BL and WA insurance.
The fields marked with * are mandatory and must be filled in!

Policy number

Policyholder

Salutation

First name

Last name

E-Mail

Phone

Claim number

Pos-Nr.

Date of loss

When and by whom was the order placed with you?

What is the order?

Is the client a prohibition customer?

Yes No

If the client is not a prohibition customer, with what sum insured was the SVS coverage provided?

Name of the injured party?

Number of packages and weight?

Sound value/trade value of the shipment according to the invoice?

Description of damage

How much is the claim?

Which SV has already been commissioned to assess the damage?

Upload files (multiple files possible)