Reporting a damage event

    Procedure when reporting a damage event

    Reporting a damage event is possible by filling out a form

    A Damage Event Report Form (OŠU) is filled in for each damage event. You must fill in all the fields contained in the form. We recommend paying attention to the method of sending money (by postal order or bank transfer) which is specified in the form. The insurance settlement is only sent in CZK.

    Documents to be sent with the Damage Event Report Form

    Under Article 4, Paragraphs 4 and 11, Paragraph 10 of the terms and conditions of insurance:

    • the original confirmation of payment (receipts made out by the doctor or by the chemists on the basis of the doctor's prescription) stating the amount and subject of payment
    • with confirmation of drugs and healthcare technical resources (crutches, glasses, prostheses, etc.) the prescription must always be submitted (or a copy thereof) made out to the beneficiary and stating the date it was drawn up and the amount. The prescription must be signed
    • medical report, results of an examination, etc.
    • the original confirmation of payment of a medical examination: if an invoice has been drawn up then the original of this invoice
    • in the case of the "repeated stay" type of insurance a written document corroborating the beneficiary's stay in the CR for a period shorter than 90 days prior to an insurance event abroad. For these purposes a flight ticket or travel ticket issued to the beneficiary will suffice, on which it is specified that the trip was made from the CR, confirmation in a passport, etc.

    Investigation of a damage event

    Any claim will be investigated on the basis of the documentation you submit. For this reason we recommend that you genuinely submit all the documents which you receive during the course of the event with the damage event report form. From the date specified on the OŠU as the acceptance date of the documentation a statutory three-month period begins for liquidation of the event. The right to payment of a settlement is subject to a limitation of 4 years at most of the date on which the insurance event took place.

    Damage Event Report Form

    pdfenDamage event report form - Foreigner's Health Insurance

     

    pdfenDamage event report form - Foreigner's Health Insurance - full version

     

    pdfczDamage event report form - Accident insurance


    pdfczDamage event report form - Accident insurance (hospitalization)


    pdfczDamage event report form - PATRON (hospitalization)

     

    pdfczDamage event report form - PATRON (incapacity for work)


    pdfczDamage event report form - Travel Insurance

     

    pdfczDamage event report form - Accident Insurance 

     

    pdfczDamage event report form -Personal Property, Third Party Indemnity, Trip Cancellation and Mountain Rescue Service Intervention Insurance

     

    Pojišťovna VZP, a.s.

     

    Jankovcova 1566/2b
    170 00  Praha 7
    Czech Republic

     

    Mo - Th: 8:00 - 17:00
    Fr: 8:00-16:00
    tel.: +420 233 006 311

    fax: +420 233 006 300
    e-mail: info@pvzp.cz

     

    Assistance service:

     

    AXA Assistance CZ, s.r.o.
    Hvězdova 1689/2a
    140 62 Praha 4
    Czech Republic

    Contacts