Today 05.02.2012
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Feedback

Dear client!

If you have any questions on the settlement of the insured event, please fill out the questionnaire.
The company will provide the answer to your request within 3 working days.
Thank you for your cooperation.

1. Name of Insured *
2. e-mail *
3. Phone number (preferably mobile, for rapid communication)) *
4. Insurance agreement (policy) number *
5. Date of Insurance agreement (policy) *
6. Type of insurance Motor insurance
MTPL (Mandatory Third- Party Liability Insurance)
Medical insurance
Other
7. Date of event *
8. request / notification *

" * " margins that are obligatory for filling

Send


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Contacts:

11, M. Raskovoy Str., Kyiv, Ukraine, 02660

Working schedule: Monday - Friday from 9.00 a.m. till 6.00 p.m.

Tel./fax: (044) 496-80-80 ,   E-mail: centre@nova-ua.com