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Apply for loss

Select the type of insurance for which you want to fill loss application

Accident insurance loss application

How to fill loss application online?

  • Choose the loss application insurance type
  • Fill out loss application
  • Add/upload documents necessary for application
  • Indicate the type of loss
  • Send the application to the insurer
  • A confirmation email will be sent to your specified email address

+Blank loss application form

Need help?


Phone: 1887


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  • Internet browser-System is recommended to use with the following internet browsers: Internet Explorer 8, Firefox 8.0, Chrome 15.0, Safari 5.1 and later version.
  • SSL certificate-data is encrypted using SSL certificate. Your browser must be selected to use the SSL protocol.
  • Adobe Acrobat reader - to open print out of the policy sent to you (PDF format), your computer must have Ado be Acrobat reader 6 or later version. You can download it here
  • Adobe Flash Player - to upload a file, your computer must have Adobe Flash Player software installed. You can download it here