MTPL insurance | File a claim

Vehicle registration number/Property name

Current vehicle mileage (km) *

Owner's name, surname/company name* *

Personal identification number/company code*

Address*

Phone number*

E-mail*

Was anyone injured? *

SUPPORTING DOCUMENTS ( PROVIDE AVAILABLE ACCORDING TO THE LIST)

The size of a single attached document should not exceed 5MB, and the maximum size of all documents should not exceed 30MB. Allowed file types: pdf, jpg, doc, xls, zip, 7z, bmp, png.

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF COMPENSATION:

Select all

I confirm I have read the Privacy Policy, the information I have provided is correct and I am fully authorized to submit this claim application and, upon request of Balcia, I will provide other necessary data and documents. I am aware of and agree on the mutual communication (including document submission) via email.

I agree that Balcia Insurance SE, acting through Lithuanian branch, and its authorized third parties process my personal data related with health condition for the purposes of handling my claim application and calculating and paying insurance indemnity.

I agree to receive information about promotions, discounts, bonuses and other marketing activities, including requests for my opinion about Balcia services. Choose

Motor Third Party
Liability Insurance

EVENT INFORMATION

INFORMATION ABOUT LIABLE VEHICLE

INFORMATION ABOUT THIRD PARTY

SUPPORTING DOCUMENTS ( PROVIDE AVAILABLE ACCORDING TO THE LIST)

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF COMPENSATION:

Subscribe for newsletter!

Motor Third PartyLiability Insurance

EVENT INFORMATION

INFORMATION ABOUT LIABLE VEHICLE

INFORMATION ABOUT THIRD PARTY

SUPPORTING DOCUMENTS ( PROVIDE AVAILABLE ACCORDING TO THE LIST)

DETAILS OF THE NOTIFIER

PLEASE CHOOSE THE METHOD OF COMPENSATION:

Subscribe for newsletter!

Motor Third Party
Liability Insurance