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SUBMIT A PROPOSAL

Viacstranovky formular EN
  • Consumer data
  • Information about the insurance company
  • Time data
  • Description of decisive facts
  • Other proceedings
  • Description of what the consumer is seeking in the proposal
  • Attachments
  • Consent
  • Summary
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How do you want to file a complaint?
An anonymous proposal to start a consumer dispute will be rejected under Section 13, para. 1, letter (d) of Act No. 391/2015 Coll. on alternative resolution of consumer disputes, as amended.

Consumer data

Name and surname
Name and surname
Name
Surname

Address of permanent residence:

Mailing address:

* mandatory information.

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