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MultiSure BV
Tosca 18 - 2926 PK - Krimpen aan den IJssel
Telefoon+31 (0)180 - 55 27 27   Telefooninfo@multisure.nl

Report a claim

Report your claim online by filling in the form on this page.
Do you need immediate help? Please call us on +31 (0)180 - 55 27 27

Report a claim

Contactperson*
Phonenumber*
Emailaddress*
Name of insured person*
Date of birth
Position
Vessel
Port
Commencement disablement
Disablement due to*
Is hospitalisation required? Yes (If Yes, please give all details i.r.o hospital/doctor)
No
Contact information hospital/doctor
Is repatriation required? Yes
No
If repatriation required, do you arrange the repatriation yourself? Yes
No
Other actions/information
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MultiSure BV 
Tosca 18
2926 PK - Krimpen aan den IJssel
The Netherlands
Telefoon+31 (0)180 - 55 27 27
Mailinfo@multisure.nl