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Notice for the insured event

To make the claims review process faster, fill in the form as accurately as possible

What happened?

Describe the event

What kind of injury has occurred?
Sports injury happened:
Cause of death
What, where and how happened? Which part of the body has been injured?
What happened and how?
Add the name of the doctor who is aware of the insured person's health in relation to the accident.
Has there been a need for hospital treatment for more than one day?

Applicant's information

Applicant is

Insured person's information

Add the name of the employer if the contract is concluded by the employer

Requisites for reimbursement

Applicant's information

Beneficiary
Applicant is:

Beneficiary's/heir's requisites for reimbursement

Do you want to encrypt the documents certifying the insured event?

After you submit the form, you will receive instructions on how to encrypt the documents

You can send the documents to atlidzibas@seb.lv

 

1. With submitting this claim, I consent to forwarding my personal and health data to the insurer SEB Life and Pension Baltic SE, who is the controller of this data.

2. I have acknowledged my data is used with the purpose to: 
-    find out more details about the claim from the State Authorities, and other health care institutions,
-    obtain data related to the insured event from law enforcement authorities
-    fulfil insurer obligations with its reinsurer
-    fulfil insurer‘s obligations provided in  Insurance Contract law. 

3. I have access to information about personal data processing and my rights, in SEB Privacy Policy, available at seb.lv

4. I certify that the data provided are correct and accurate.

We inform you that the information related to the insurance indemnity will be sent electronically by the Insurer to the e-mail indicated in this application. If I have chosen to use unencrypted e-mail for communication, I confirm that I am aware that the chosen e-mail is not a completely secure communication channel.

If the insured person becomes involuntarily unemployed

  1. Fill in the online application for forced unemployment indemnity
    Fill in the indemnity application (PDF, LAT)
  2. Upload the application with documents confirming the insured event using a secure environment for signing electronic documents:
  • A statement from the State Employment Agency on the granting of unemployment status
  • A statement from the State Social Insurance Agency regarding the granting of unemployment benefit
  • A statement issued by the State Social Insurance Agency regarding the compulsory social insurance contributions paid for the last 6 months before the date of termination of the employment relationship
  • A document indicating the reason behind terminating the employment relationship
  • The employment contract 
  • Documents for the continuing of unemployment
  • In order to receive each subsequent indemnity, if the involuntary unemployment continues, you must submit a statement from the State Employment Agency regarding the status of the unemployed

Upload and sign the application

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