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  • Home Insurance Claim Form

  • IMPORTANT NOTES

    Insurers, their Agents and Insurance Associations share information with each other to prevent fraudulent claims and for underwriting purposes. In the event of a claim, some or all the information you supply on this form and the proposal form together with other information relating to the claim may be provided to other Insurers, their Agents and Insurance Associations.

    ALL RELEVANT QUESTIONS MUST BE FULLY ANSWERED

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  • Statement of claim

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    • Check what documents you may need 
    • Submission of: Photos of damaged items being claimed Technical report/quotation submitted by the repairer/technician/retailer etc. Police Report (if applicable) Water Tracing Agents / Water Leak Repairs report (if applicable)
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  • Signatures

  • I/We hereby declare that the above information and statements are, to the best of my/our knowledge and belief, correct and complete.
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  • Please use the space below to provide your signature directly
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  • DATA PROTECTION MAPFRE Middlesea p.l.c. is legally bound to follow the provisions of the Data Protection Act, 2001. MAPFRE Middlesea p.l.c. is registered with the Office of the Commissioner for Data Protection to process data in accordance with this Act. The Data Protection Policy of MAPFRE Middlesea p.l.c. is compliant with this Act, a copy of which is available on request.

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