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Letter templates

Insurance claim template to send by fax

Water damage, theft, fire, broken glass: describe the loss, attach photos and supporting documents, and send your claim within the deadline set by your contract.

In short

Report a loss as soon as you become aware of it, within the deadline set by your contract: never less than 5 working days, 2 working days for theft, and 30 days after the decree is published for a natural disaster. A fax works if your contract allows it; the PDF acknowledgment then dates your claim. After a natural disaster, the claim must be sent by registered letter.

Fill in the template

Everything happens in your browser: nothing is sent or stored until you submit the sending form.

This letter is addressed to a French organisation, so it is written in French and the PDF will stay in French. Please fill in the fields in French, using Latin characters.

Your details

One address line per line.

So the recipient can reply.

Recipient

In French, for example "Service sinistres".

Printed on the letter and carried over to the sending form. Check it on a letter from the organisation or in the site's directory.

Letter content

In French, for example "dégât des eaux" (water damage), "vol" (theft) or "incendie" (fire).

Or of its discovery.

What happened, in order, in French.

Property affected and its condition.

Neighbour, other driver, accident report…

In French, for example "plainte du 6 mai, commissariat de Lyon 3e".

One item per line. Add the files further down, under "Attachments".

Place and date

Where you are writing from, as in "À Lyon, le…".

Defaults to today.

Signature and attachments
Optional. A sharp photo on a white background, PNG or JPEG. Without an image, space is left to sign by hand.
Optional. PDF, JPEG or PNG: they are placed after the letter, in the same document.

One-page document: free, unlimited sending.

To generate the PDF, fill in: Your first and last name, Your postal address, Insurer, Contract number, Type of loss, Date of the loss, Place of the loss, Circumstances, Damage observed, Town or city.

Need proof? When sending, the optional PDF acknowledgment of receipt (€3.99 incl. VAT) records the date and transmission of the fax. Keep it with a copy of the letter.

Letter preview

The letter exactly as it will be sent. Fields still to fill in are highlighted.

[Prénom Nom][Adresse postale]

[Organisme destinataire]

À [Ville], le [date]

Courrier envoyé par télécopieContrat n° [numéro]

Objet : Déclaration de sinistre — contrat n° [numéro]

Madame, Monsieur,

Titulaire du contrat n° [numéro], je vous déclare par la présente le sinistre décrit ci-dessous.

Nature du sinistre : [nature du sinistre]

Date : [date du sinistre]

Lieu : [lieu du sinistre]

Circonstances : [circonstances]

Dommages constatés : [dommages constatés]

Je vous remercie d’enregistrer cette déclaration, de m’en communiquer la référence et de m’indiquer la suite de la procédure (expertise, pièces complémentaires). Je tiens à votre disposition tout justificatif utile ainsi que les biens endommagés, sous réserve des mesures conservatoires nécessaires.

Je vous prie d’agréer, Madame, Monsieur, l’expression de mes salutations distinguées.

[Prénom Nom]

How to fill it in

  1. 1

    Limit the damage, then record it

    Turn off the water, secure the premises, photograph the damage before any repair. Keep the damaged items and purchase invoices.

  2. 2

    Describe it precisely

    Date, place, circumstances, damage, third parties: a precise claim avoids back-and-forth. For theft, report it to the police first and say so.

  3. 3

    Attach the documents

    Photos, invoices, quotes, police report receipt, accident report: add them under "Attachments" and they will follow the letter.

  4. 4

    Send within the deadline

    Fax the claim to the claims department number shown on your contract or renewal notice, with the PDF acknowledgment of receipt to date it.

Check before sending

  • Reporting deadlines

    The contract sets the deadline, which cannot be shorter than 5 working days from discovery of the loss, or 2 working days for theft. If you are late, the insurer may refuse to pay if it proves the delay harmed it.

  • Natural disaster: 30 days, by registered letter

    The claim must be made no later than 30 days after the natural disaster decree is published in the Journal officiel, and sent by registered letter, preferably with acknowledgment of receipt.

  • Check the accepted reporting methods

    Your contract says how to report a loss: online account, phone, post, sometimes fax. If fax is not listed, use it in addition to an accepted method, not instead of one.

  • Wait for the assessment before repairing

    Emergency measures (tarpaulin, turning off the water) are expected of you. Permanent repairs are better left until the insurer agrees or the loss adjuster has visited: otherwise the damage becomes hard to prove.

Template provided for information, checked on October 8, 2026 against the official sources below. It does not replace advice from a legal professional, nor the terms of your contract.

Official sources (in French)

Send this document by fax

A one-page fax is free and unlimited, with no sign-up. From two pages, sending costs €3.99 incl. VAT. To prove you sent it, add the PDF acknowledgment of receipt (€3.99 incl. VAT).

Fill in the template

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