Damage Claim

    YOU CAN USE THIS FORM TO REPORT DAMAGE. WE WILL THEN GET IN TOUCH WITH YOU AS SOON AS POSSIBLE

    Your identity

    Name
    Required

    First name
    Required

    Full address
    Required

    E-mail
    Required

    Phone / mobile
    Required

    DETAILS OF DAMAGE OF ACCIDENT

    Policy number(s)
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    Date of damage occurring
    Verplicht in te vullen

    Time of accident
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    Where did the event take place ?
    Required

    What exactly happened ?
    Required

    Extent and description of the damage
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    Identity of other party
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    Report number
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    Upload a file
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    Additional question or information
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    How much is six + 3 ? (*)
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    NEWSLETTER

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    Contact DETAILS

    IRIS Photo Equipment Insurance
    Jan Van Rijswijcklaan 212
    2020 Antwerpen
    FSMA nr 013463 A
    Tel +32 3 241 08 89
    iris@adwverzekeringen.be