Reporting damage – correct reporting of the event

In the event of an accident or breakage, it is important that both parties complete the damage form. Only a correctly completed document will ensure that our compensation will be valued correctly, it will also speed up obtaining the amount due.

Instructions for the procedure in the event of a collision

  • Be sure to complete the claim form with the driver of the other vehicle. It is very important that both parties sign the document. We recommend filling out the form at the event site so that all information is completed correctly.
  • Complete the document also on the back of the first page. Then hand over the form to our specialists.
  • If there were witnesses at the scene, it is a good idea to ask them for their name and contact number. It may happen that this person will be needed as a witness.
  • Did both parties fill out a damage form? The next step is to take pictures of the damage of both vehicles. This will give the insurance company a more complete picture of what actually happened.

Damage form – how can you send it to us?

According to the terms and conditions of the insurance policy, it is the insured’s obligation to inform us about the road accident as soon as possible. For your convenience, there are two ways to do this:

When contacting us, please prepare:

  • Your policy number
  • Date of occurrence of the accident/damage,
  • The cause of the damage (if known).
  • Approximate repair amount (if known).
  • Opposing Party personal information

Additional information on collision damage can be found in our brochure.

In writing:

Download the damage form here and print it.

Then send the completed document to the following address:

Polisa.nl
Burgemeesters Godschalxstraat 59
5235 AB, ‘s-Hertogenbosch

Or by email at: info@polisa.nl

By telephone:

Report your situation to our specialists between 09:00 and 17:30,
by phone: 088 1021 544

You are not able to report the damage right away? No problem, it can be done within 72 hours.

Polisa.nl Claim form Reporting damage

When contacting us, please prepare:

  • Your policy number
  • Date of occurrence of the accident/damage,
  • The cause of the damage (if known).
  • Approximate repair amount (if known).
  • Opposing Party personal information

Additional information on collision damage can be found in our brochure.

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