Obligatory fields are marked with an asterisk (*). Please select your broker* Select your broker Finnrisk Finpremium Rewenda Söderberg & Partners En ole varma Contact Details Informer* Policy holder/Employer* Phone* Email* Incident Information Damage Location / Address Date of Damage Information About Your Own Vehicle Name of your driver Personal identification number of the driver Home address of your driver Your driver's email address* Own vehicle registration no Is the vehicle subject to VAT deduction? * -- Select -- Yes No Was anyone involved in the injury under the influence of alcohol or other drugs? * -- Select -- Yes No Did the driver have a driving license?* -- Select -- Yes No Counterparty Vehicle or Other Property Which Is Damaged The name of the other party driver or owner of the property Counterparty driver or the property owner's e-mail address Counterparty driver's phone number CCP vehicle Reg Additional Information Who do you think is to blame for the injury? Description of the event Additional information available from Upload attachments for your claim (Total size of attachments max. 12 MB.) Drop files here to upload By sending the form, you agree that we will keep the information you provide and pass it on to fulfill our contractual obligations, if necessary, to persons within our group, insurance companies, occupational pension institutions, Kela, health service providers, customer communities and the persons mentioned in the notice. If necessary, we can also hand over information to the competent authorities in order to fulfill the brokerage company's legal obligations. We store information as long as it is necessary to fulfill the purpose of use or as long as there is a legal obligation to store it. We may store e.g. certain transaction information or correspondence until the time limit for making claims for that transaction expires. We delete personal data when it is no longer necessary to store it on the grounds mentioned above. You can withdraw your consent to the processing of your data at any time by sending an email to info.finland@soderbergpartners.com. Submit
