Balcia | credit card claims

EVENT INFORMATION

Event date *

Event time *

Event country *

Address *

Event circumstances *

Bank name *

Type of credit card *

Information about card owner's data

Name *

Surname *

Personal code *

Phone number *

E-mail *

Bank account *

Information about the suffered person

Was there a suffered person?

Is the suffered person the credit card owner

Supporting documents

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, rar, zip, 7z, bmp, png.

Attach documents (photo of damages, other)

Upload document

Document *

Applicant Information

Notifier is the credit card holder

Notifier is the suffered person

Other

Name *

Surname *

Personal code *

Phone number *

E-mail *

Have you lodged a claim with another insurance company?

Yes

I confirm I have read the Privacy Policy and its content is clear and understandable to me. I agree that Balcia and its authorized third parties process my personal data (including health-related data) in order to administrate my claim and calculate and pay the insurance indemnity.

credit card insurance

EVENT INFORMATION

Information about card owner's data

Information about the suffered person

Supporting documents

Attach documents (photo of damages, other)

Applicant Information

Have you lodged a claim with another insurance company?

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credit card insurance

EVENT INFORMATION

Information about card owner's data

Information about the suffered person Suffered person - the person for whom an application for compensation is submitted, in connection with the deterioration of health or medical expenses

Supporting documents

Attach documents (photo of damages, other)

Applicant Information

Have you lodged a claim with another insurance company?

Subscribe for newsletter!

Information about the suffered person