Incident note

Fill in the following fields with your data in order to complete the incident note.

Policyholder & policy

Policyholder


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Policy information

   
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Contact person


   
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Insured person

Personal data


Bank account

Bank account information is required for direct payments to the insured or if the employment contract has been terminated.

   
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Personal details



   
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Accident report

Accident details

   
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Accident information

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Injury

Main Injury

   
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Other injury 1

   
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Other injury 2

   
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Treatment

Doctor / hospital that provided initial treatment


   
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Subsequent treatment by doctor/hospital


   
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Send and Print

          
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The PDF contains the key details on the registered incident report. For technical reasons, not all details entered can be seen in the PDF.
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Operator help

Do you have technical questions about BBTClaims?
Sunet Helpdesk +41 41 455 30 30
(Mo-Fr, 8am to 12pm and 1pm to 5pm)

Do you have any questions about the insurance or policy?
+41 800 809 810
Version: 22500