ARCHIVE - Claim report Immoweb Protect

Home insurance for owner: incident report

We are sorry to hear about your incident.
Please follow the steps below to file a claim and report the incident.

If you need urgent assistance, call Baloise Assistance available 24/7: +32 3 870 95 70.

Not sure? Do you have a question?

Our team is always at your service to help you.
Phone: 02 588 25 50
Email: claims@qover.com

Note: your claim may be subject to a deductible. Please review your contract carefully before filing your claim, or have another look at our terms & conditions to know more about it.
Personal Information
First and last name*

First nameLast name
Your contract reference number*
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Phone number*

Area CodePhone Number
Email*
Your account number in IBAN format if your claim is accepted *

Please specify which coverage you want to use, making sure that you added the corresponding options to your contract when you subscribed.
Building*
Are there damages to the building (water, fire, smoke, glass breakage, etc.), or to a neighbour's?
Content*
Has the content of your home been damaged?
Theft or attempted theft*
Family Liability*
Have you or a member of your household caused injuries or damages to another person or their property?
Legal protection*
TPA*

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Building
Please describe the damage caused to or by your building as well as the circumstances of the incident
Were you injured as a result of this incident? Describe your injuries.
Please provide us pictures of the damages*

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Please upload any document related to the incident that might be useful

For example: police report, complaints, invoice, quote, medical certificate, etc.
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Damage to content
Please describe the damages caused to or by your content as well as the circumstances of the incident
Please provide us pictures of the damages*

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Please upload any document related to the incident that might be useful

For example: police report, complaints, invoice, quote, medical certificate, etc.
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Theft or attempted theft
Describe the circumstances in which the theft or attempted theft took place and the damage and loss you suffered as a result of the theft to your building and/or contents*
Were you injured during the theft or attempted theft? Describe your injuries.
Did you receive the police report?*

YesNo
Please note that a complaint must be made to the police within 24 hours of discovery of the theft (or attempted theft).
Please add your Police Report in the documents.
If you do not have it yet, please ask the police for a copy.
Only the items that are reported in the Police Report will be eligible for compensation.
Please upload the police report*

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Please upload any document related to the incident that might be useful

For example: invoice, picture, quote, warranty, certificate, medical certificate, pictures of the packaging,...
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Family civil liability
Please describe the causes and circumstances of the incident as well as the damage (injuries, material or financial) that you have caused to the third party*
In what way is your liability engaged?
Where did the damage occur?*
Who caused the damage?*
What is your relationship or responsibility to this person?
Please upload any document related to the incident that might be useful

For example police report, pictures, complaints, invoice, quote, medical certificate, etc.
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Legal protection
In what context do you have a conflict?*

Your private life (family)Your home (building/content)
Describe to us the circumstances and the chronology of your conflict (including possible harm and/or the cause of the infraction)
Please upload any document related to the incident that might be useful

For example: police report, complaints, invoice, quote, medical certificate, etc.
Cancelof

Repair in kind
Do you have damage to your building following an incident and would like to have it repaired?
Choose our network of repairers and benefit from the following advantages:
- Contact by a repairer within 8 hours. Guaranteed quality and fair price.
- Removal of the standard deductible if the damage to your building exceeds the amount of the deductible.
- Payment of the invoice by Baloise directly to the repairer.
If repair is not technically possible, a replacement will be offered.

Conditions to benefit from these advantages :
These benefits only apply to damage to the building that is covered by your Home Protect insurance and that was not caused by a third party.

What is the standard deductible?
In home insurance, a deductible is applied when a claim is covered, i.e. an amount of money that you are responsible for paying.
The deductible is standard when there has been no increase in your deductible.
It changes each month according to the consumer price index. In January 2021, the deductible was €266.10 (at CPI 256.85). The reference is a basic deductible of €123.95 based on the 1981 CPI 119.64.
Do you want the damage to be repaired in kind? (By accepting repair in kind, you will not receive any further compensation for these identified damages.)*

YesNo
Do you have any additional information to communicate about the repairs to be made?

Data Protection, Fraud Prevention and Detection
In order to administer your claim, this information will be used by Qover, the claim adjuster and the insurer. It may be held on computer and or in manual files for administration and risk assessment purposes. By returning this form, you consent to our processing of your sensitive personal data for the above purposes. You also consent to our transferring of your information to countries which do not provide the same level of data protection as Belgium, if necessary for the above purposes. If we do make such a transfer we will, if appropriate, put a contract in place to ensure your information is protected. Where you have provided information about another person, you confirm that they have appointed you to act for them, to consent to the processing of their personal data, including sensitive data, to the transfer of their information abroad and to receive on their behalf any data protection notices.
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Home insurance for owner: incident report

Personal Information

Information about the incident

Building

Damage to content

Theft or attempted theft

Family civil liability

Legal protection

Repair in kind

Data Protection, Fraud Prevention and Detection