Tema
Debat

Skadeanmeldelse - motorkøretøj

Er du blevet påkørt af et ukendt motorkøretøj eller af et motorkøretøj uden ansvarsforsikring, skal du udfylde nedenstående skadeanmeldelse og trykke på "Send".

 

Skadeanmeldelsen bliver automatisk sendt til DFIM. Vi kontakter dig og forklarer sagens videre forløb, når vi har modtaget din skadeanmeldelse.

 

Har du spørgsmål til skadeanmeldelsen, kan der ske henvendelse på tlf. +45 41 91 90 19, hverdage kl. 10-15.

 

Her kan du læse om vores behandling af dine personoplysninger i forbindelse med en skadesag:

 

Privatlivspolitik - Skade DFIM

 

 

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{{are_you_vat_registered}}
{{who_is_claiming}}
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{{postal}}
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{{email}}
{{name}}
{{address}}
{{postal}}
{{phone}}
{{email}}

{{information_about_the_accident}}

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{{postal}}
{{information_accident_place_description}}
{{when_did_the_accident_happen}}
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{{describe_the_accident}}

{{damage_to_vehicle}}

{{has_your_vehicle_been_damaged}}
{{describe_damage}}
{{regno}}
{{model_brand}}
{{year}}
{{vehicle_in_company}}
{{is_the_vehicle_comprehensively_insured}}
{{insurance_company}}

{{driver_of_the_vehicle}}

{{driver_same_as_the_injured_party}}
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{{address}}
{{postal}}
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{{personal_injury}}

{{was_there_any_personal_injury}}

{{Person}} 1

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{{cpr}}
{{name}}
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{{postal}}
{{do_you_have_accident_insurance}}
{{accident_insurance_company}}
{{been_to_emergency_room}}
{{work_related_injury}}
{{member_denmark}}
{{sick_leave_accident}}
{{sick_leave_from_date}}
{{to_date}}
{{still_on_sick_leave}}
{{information_about_work_situation}}
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{{received_or_are_you_still_receiving_treatment}}
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{{name_address_general_practitioner}}
{{other_info_treatment}}
{{describe_person_damage}}

{{damage_to_things_including_bicycles}}

{{damage_related_to_the_accident}}
{{damage_to_the_means_of_transport}}
{{other_property_damage}}
{{family_home_insurance}}
{{bicycle_involved_in_the_accident}}
{{you_own_the_bike}}
{{if_yes_which_company}}

{{the_other_party}}

{{is_there_a_known_other_party}}
{{name}}
{{address}}
{{postal}}
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{{car_brand_type}}
{{regno}}.
{{insurance_company}}
{{green_card_no}}
{{additional_info_other_party}}
{{who_has_the_information}}
{{is_other_party_hidnrun}}
{{other_information}}
{{is_other_party_hidnrun}}

{{police_report}}

{{accident_reported_police}}
{{police_jurisdiction}}
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{{witnesses}}

{{witnesses_to_the_accident}}

{{witness}} 1 {{add_witness}}

{{name}}
{{address}}
{{postal}}
{{phone}}
{{email}}
{{location_witness}}

{{more_information}}

{{banking_details}}

{{send_money_bank}}
{{send_money_nemkonto}}
{{regno}}
{{accountno}}

{{documentation}}

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{{morefiles}}
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