Claim report form

Report your vehicle claim here

Customer data

In which country was the contract concluded? *

VIN number *

contract number / financing number

Title *

first name

last name *

Street and house number

postal code

place

E-Mail *

phone

Vehicle data

current mileage *

first registration *

Upload your attachments here. Maximum 5 files.

upload file (PDF)

upload file (JPG, PNG)

Upload for example cost estimates, images, registration certificates, maintenance certificates, orders, etc. Permitted formats

Describe the nature of the damage: *

Friendly Captcha

*I have read the privacy policy. I agree that my details and data will be collected and stored electronically to answer my request.

Note: You can cancel your consent at any time for the future by sending an e-mail to info@cargarantie.com.

* Mandatory field

garage data

In which country was the contract concluded? *

CG dealer number

name of the repairing garage *

contact person *

phone *

e-mail *

contract number / financing number

VIN number *

client data

title *

first name

last name *

street and house number

postal code

place

vehicle data

first registration *

occurrence of damage

current mileage

maintenance checked

Estimated labor costs in EUR

Must only be completed if no cost estimate is attached.

Estimated material costs in EUR

Must only be completed if no cost estimate is attached.

Which components are damaged?

Must only be completed if no cost estimate is attached.

Describe the nature of the damage: *

Upload your attachments here. Maximum 5 files.

upload file (PDF)

upload file (JPG, PNG)

Upload for example cost estimates, images, registration certificates, maintenance certificates, orders, etc. Permitted formats: PDF, JPEG, PNG

Friendly Captcha

*I have read the privacy policy. I agree that my details and data will be collected and stored electronically to answer my request.

Note: You can cancel your consent at any time for the future by sending an e-mail to info@cargarantie.com.

* Mandatory field