Reporting an insurance claim

To report an insurance claim, please fill in the fields below (required fields are marked with an asterisk) and submit the report to Drivalia Lease Czech Republic s.r.o. using the Submit button at the bottom of the form.
In case of any doubts or queries on processing an insurance claim on the vehicle, you will be contacted by our staff in order to fill and specify any additional details, so that the insurance event can be properly claimed.

1. Contact details of the person filling out this claim

2. Reporting a vehicle insurance claim to Drivalia

3. Details about how the damage happened, its cause and location of the event

4. Drivalia Lease Czech Republic s.r.o. Vehicle

5. Driver

6. Contact person at your company for possible supplementary information to add to this event

7. Information about the Police

8. Another accident participant (damaged, harmful vehicle)

This section is filled only during the actual fault or blame by another person (you fill in the entry point 2)

Driver

The other party of the accident or its representative

Owner

Information on the other party's insurance company

This section is filled out only in case of own fault (Drivalia vehicle damaged another vehicle/person/property) or in case of fault by another person (please fill in the entry field 2)

9. Additional information you may have about the insurance claim (photos, Police protocol, report on the traffic accident, etc.)

10. DRIVER'S SERVICE for insurance claims

If you are interested in having your vehicle repaired through DRIVER'S SERVICE for insurance claims , please provide the additional information and we will arrange the repair for you shortly. (If you're sending this request outside of business hours or on weekends, you will be offered this option on the next business day.)

Driver's service is an optional service consisting of a comprehensive solution for vehicle repair after a damage event. It includes finding a suitable car service, suitable date and providing a replacement vehicle free of charge according to the supplier's availability and capacity.

Drivalia is committed to protecting and securing the personal information it collects and processes. More information on the conditions of personal data processing can be found in Statement on Privacy.
Items marked with * are mandatory.