Claim has not been sent to Seesam yet. After entering the data and the files, click “Save claim”.

Loss adjustment form for personal accident insurance

Seesam must be notified of damage as soon as possible, but not later than within three working days of the occurrence of the insured event. Please fill in the claim form below with information that is as accurate as possible in order to submit a claim. A claim that is correctly filled in can be sent directly to a loss adjuster. We will contact you if we need more information.

Confirmation of your claim will be sent to the e-mail address indicated in the claim. If you haven’t received the e-mail within an hour, please try to file the claim again or call us on 628 1700.
The fields marked with * are REQUIRED fields!

Insured person

What happened

Loss amount

    Choose files...
    Please also submit the documents related to the event. E.g. documents (purchase receipts) evidencing the costs, a copy of the emergency record (if any), printout of an electronic certificate of incapacity for work, extract from a medical history and other such documents.
    Formats: jpg, jpeg, png, txt, doc, cdoc, ddoc, docx, docm, pdf, xlsx, xls, htm, html, asic, asice, xml, gif, mov, mp3, mp4, zip, rar, msg, bmp, ts, dav, avi, tmp, tif, tiff
    Do you have a similar contract with another insurance company? *


    If the fields of the application have been correctly filled in, click ‘Save claim’ and you will be directed to another page. If a field of the application has not been filled in, you will be directed to the field where the information is not correct.


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