Vehicle and traffic insurance damage

NOTIFIER DATA

First name and surname of the notifier

Personal code

Telephone

E-mail

The address of the notifier

The person reporting the damage is the vehicle’s driver

Description of loss event

Date of loss event

Time of loss event

The address of loss event

Description of the loss event and circumstances of the occurrence

Are you the person that caused the traffic accident*

Yes

No

Were any people injured*

Yes

No

Was the police notified*

Yes

No

Was the police present at the scene of accident

Yes

No

Was a written account prepared at the place of accident?*

Yes

No

In case of a traffic accident, are the details of another vehicle known*

Yes

No

Details of my vehicle

Vehicle registration number

Make and model of the vehicle

In which county do you wish to restore the vehicle?

Whether there was any other material damage besides the damage to the vehicle?

Please specify

Additional information/ Questions

Files

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If possible, please provide documentation of the incident (accident report, diagram, photos of the scene, injuries of the vehicle(s)).

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Lisateave

Salva Kahjukäsitluse OÜ-l on vajadusel õigus nõuda õnnetuse asjaolude ja õnnetuses osalejate kohta täiendavaid andmeid. Käesoleva teate vastuvõtmine Salva Kahjukäsitluse OÜ esindaja poolt ei tähenda kahjujuhtumi kindlustusjuhtumiks tunnistamist.

I declare that all the information provided in the loss even report is true

I have read and agree with the Data Processing Policy of Salva Insurance

Vehicle and traffic insurance damage notification

DATA OF THE DRIVER

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Vehicle and traffic insurance damage notification

DATA OF THE DRIVER