House hold claim Form | RSA Ireland Insurance

Household Claim

Broker/Bank/Intermediary name

Name (of Policyholder)

Policy Number

Postal Address of Policyholder

Your Name

Content limited to 80 characterserror-wrapper, remaining: 80

Your Email address

Your Phone number

Date of Incident

E.g., 03-11-2024

Location of incident

Incident circumstances

Has the house become uninhabitable due to the incident?

Description of lost/damaged property

Estimated cost of repair/replacement

Content limited to 100 characters, remaining: 100

Further details

Content limited to 250 characters, remaining: 250

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This data once submitted, cannot be directly amended by you at a later point. A Claims handler will be in contact to discuss your claims notification, as per the inputs you have supplied.