Online claim form

Reimbursement

I need assistance

Other request

In connection with the insurance event I declare the following:

I have not received any indemnity in connection with the above mentioned event.

I have not another insurance coverage of the same risk in another insurance company;

Declaration & Customer's Data Privacy Consent:

I confirm that I am the claimant and/or the Policyholder and I declare that all the particulars given above are to the best of my knowledge true and correct.

In line with the General Data Protection Regulation (GDPR)
In connection with my claims, I give consent for CORIS Bulgaria Ltd. and their respective representatives or agents to collect, use, store, transfer and/or disclose the information concerning me, to or with all such persons (including any third party service provider, and whether within or outside of Bulgaria) for the purpose of enabling CORIS Bulgaria Ltd. and their respective representatives or agents to provide me (where applicable) with services required of an insurance provider, including the evaluating, processing, administering and/or managing my claims and for the purposes set out in CORIS Bulgaria’s Confidentiality policy which can be found at http://www.coris.com.

I, the claimant declare and agree with the above mentioned