• Client Details
  • Loss Details
  • Third Party Details

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

Damage to property of others
Details of articles stolen (IMPORTANT)
Description of articles (please state serial numbers or any other identifying marks) Date and Place of purchase Price paid Replacement price Deduction for depreciation Amount claimed