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 Damage Location / Address Date of Damage Planned start date of the trip Planned end date of the trip Description of the event If Your Trip Has Been Canceled Travel booking date Trip cancellation date Has it been possible to obtain reimbursement from the tour operator or travel agency for the costs of the cancellation? -- Select -- Yes No Injured Person's Information Name Security ID* Home address* Account number Additional Information Have the costs already been incurred? -- Select -- Yes No Please provide the sum of the costs of the transaction Has the injured person been covered for the costs he / she has incurred? -- Select -- Yes No When did the symptoms of illness or accident begin? Has the injured person visited a doctor? -- Select -- Yes No When did you first see a doctor for an incident? Upload attachments for your claim You can attach several files by pressing the ctrl key. (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
