Theft/Burglary

Surname(Required)

First name(Required)

Company(Required)

Phone number(Required)

Email(Required)

IBAN number

Date of damage or when a problem was first detected(Required)

Location of damage (address)(Required)

How did the damage occur(Required)

What was stolen? (If available, please attach proof of purchase)

Is there evidence of a break-in? / What was damaged?

Estimated amount of damage in CHF

Please enter a number greater than or equal to 0.

If yes: Police station, date of report and officer in charge

Remarks

Drop files here or

Max. file size: 5 MB, Max. files: 5.

(You can add up to five attachments here. You are welcome to submit any additional documents to schaden@verlingue.ch.)

Claim forms