ERGO

My details Edit

Private person
Legal person
Repair shop

Company name *

Company registry code *

Details of reporting person

Name of repair shop

Registry code of repair shop *

E-mail of repair shop

Details of reporting person

Personal identification code *

Name *

Surname *

Telephone *

E-mail *

Country of residence *

What happened? Edit

Time of event *

Enter location using the map application

Enter the exact location of the event by clicking on the map.
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Cause of damage *

Description of the event * Describe how the event happened and what may have caused it

0 Characters left

Were the police notified about the event?

Yes

If the event had any witnesses, specify their names and telephone numbers

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Who and what was involved in the event? Edit

First enter the details of your vehicle
If your vehicle was not involved in the event, enter the details of the vehicle that caused the damage.
When entering the registration plate, please do not leave space between numbers and letters (for example 140MLS).

Remove the vehicle

Unknown vehicle

Reg. number *

Mark *

Model *

Year *

Description of damage to the vehicle *

0 Characters left

I was the driver

The driver is known

The driver is not known

Driver

Personal identification code *

Name *

Surname *

Telephone

E-mail

Country of residence

Remove

The driver was drunk

The driver of this vehicle is responsible for causing the accident

More vehicles were involved in the incident?

Yes

If there were any other vehicles involved in the event, add the vehicles by clicking the button below

Vehicle

Unknown vehicle

Description of damage to the vehicle

I was the driver The driver is not known

Personal identification code

Name

Telephone

E-mail

Country of residence

The driver was drunk

The driver of this vehicle is responsible for causing the accident

Additional information Edit

Additional information about the event

Adding files

Add the following photos and documents, if available:
- photos of vehicles and other damaged objects, and of the scene of the event
- written report drawn up on the accident

Drag files here or click to select files

Indemnities Edit

I apply for indemnification for the damage caused:

Yes, on the basis of a comprehensive insurance contract

Yes,on the basis of a traffic insurance contract

No, I am notifying of the event as a person causing the traffic accident or as a witness

Damage caused

Vehicle damage

Beneficiary *

Name of beneficiary

Bank account number

Expected amount of damage

Expenses for removal of the vehicle

Beneficiary *

Name of beneficiary

Bank account number

Expected amount of damage

Other expenses

Beneficiary *

Name of beneficiary

Bank account number

Expected amount of damage

Description of damage

Replacement car

The right to use the replacement car exists only if the vehicle is covered by ERGO comprehensive insurance and the respective insurance cover has been chosen

Rental start date:

until

I confirm that the information given above is correct and complete. I am aware that the insurer has the right to reduce or refuse to pay out the indemnity if I have knowingly given incorrect information. I agree that the insurer has the right to request additional information concerning the loss event from people who possess such information.

My details Edit

Details of reporting person

Details of reporting person

What happened? Edit

Who and what was involved in the event? Edit

Driver

Additional information Edit

Adding files

Indemnities Edit

Important information

Look for car repair shop

Notice

Customer service

My details Edit

Details of reporting person

Details of reporting person

What happened? Edit

Who and what was involved in the event? Edit

Driver

Additional information Edit

Adding files

Indemnities Edit

Important information

Look for car repair shop

Notice

Customer service

Personal identification code

Phone number

Personal identification code

Personal identification code

Phone number

Personal identification code