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.
Under Article 4, Paragraphs 4 and 11, Paragraph 10 of the terms and conditions of insurance:
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 - Foreigner's Health Insurance
![]()
Damage event report form - Foreigner's Health Insurance - full version
![]()
Damage event report form - Accident insurance
![]()
Damage event report form - Accident insurance (hospitalization)
![]()
Damage event report form - PATRON (hospitalization)
![]()
Damage event report form - PATRON (incapacity for work)
![]()
Damage event report form - Travel Insurance
![]()
Damage event report form - Accident Insurance
Jankovcova 1566/2b
170 00 Praha 7
Czech Republic
fax: +420 233 006 300
e-mail: info@pvzp.cz
AXA Assistance CZ, s.r.o.
Hvězdova 1689/2a
140 62 Praha 4
Czech Republic
Contacts