Online Claim Form
Contact Information
Customer Number
Company Name
Contact Name and Surname
Email:
Phone:
Vehicle Information
Plate Number
Brand/Model
Delivery Date of the Vehicle
Detailed Description of your Claim
What do you expect from BCA? (please mention the amount of your claim)
Add Photos and/or Documents
(File formats accepted: pdf, jpg, tiff, png, gif. Individual files may not exceed 2 MB.)
The asterisk "
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Contact Information