Your First name/Last name

Address

Postal code/ CITY

[Name of your insurer]

Address

Postal code/ City

Done in [your city], on [specify the date].

Subject: Claim declaration covered by home insurance policy [indicate your policy number]

Madam, Sir,

I am the owner of a home located at [indicate your address]. My house / apartment located at [specify the address of the property] has suffered [specify the nature of the damage].

Consequently, I would like to activate the insurance policy I subscribed to on [indicate the subscription date of the contract].

While awaiting your reply, please accept, Madam, Sir, the expression of my best regards.

[Your signature]