• Client Details
  • Loss Details
  • Particulars

Claim Form

Complete and Accurate information must be given in this Claim. Zimnat reserves the right to verify the authenticity of all submitted documents and to prosecute any fraudulent actions
All Fields marked with * are mandatory.

Full name separated by space
Time and Place of Loss
Give details of the circumstances leading up to the damage

No. of Articles Description of the property destroyed or damaged Date of Purchase Cost of purchase Deduction of age wear and tear Value of salvage Amount