Check request

We can send you a check for payment if the premium is collected by CLB from you. If the premium is collected by the insurance company directly, then please provide your data under the "Information request" menu point as listed below, so as we can transfer your request to the insurance company.
Contract identification number (Filling out is mandatory)
Name of the contracting party:
CLB Contract identification number:
Policy number:
Zip code of the contracting party:
City of the contracting party:
Street name of the contracting party:
Telephone number:
E-mail:
License plate number of the vehicle (format: AAA-111):
Type of the contract:

CASCO GFB Apartment Liability Other