File a claim

Private individuals

File a claim

Simply fill in the form below and we will contact you at the time of your choosing in order to work together to file your claim.

Please fill in all required fields *

Type of incident

Car

Home

Other

Select incident

Mrs.

Mr.

Surname

Name

Postal code

Policy number

Description of your claim:

When did it happen?

I would like to be contacted by:

Phone

Preferably on

Please choose a time:

Phone

Protection of personal data

By sending your enquiry you are consenting to us processing your data for the purpose of responding to your enquiry. In all cases where data processing is based on your consent you have the right to revoke this consent at any time. The revoking of your consent does not affect the legality of the data processing carried out up until the revocation based on your former consent. Further information can be found in our privacy policy.

Send

Contact

Find an agent

Report a claim

myBaloise

Leave your opinion about Baloise