Report form

Please report the claim on the vehicle.

Personal data

Last name*

First name*

Road

No.

Postal code

City

Phone

Email*

Data of the vehicle

Policy number*

Date of damage

Registration number

ID-number of your vehicle*

Mileage*

Data of the claim

How does the damage manifest itself?

What is your diagnosis of the damage?

Estimated wage costs: EUR

Estimated material costs: EUR

Where is your vehicle at the moment? (If applicable, name of the garage which will repair the vehicle)

Who should CarGarantie contact? (If applicable, name of the garage which will repair the vehicle)

Phone

* I have read and taken notice of the Privacy Policy. I agree that my details and data will be collected and stored electronically to answer my request.

Note: You can revoke your consent at any time via e-mail to info@cargarantie.com.

* Mandatory field