Bikmo BE - Concordia Claim Form (EN/FR/NL) Logo
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  • Guidance notes

     

    The Bikmo claim form uses the Jotform application. You can save your progress at any time, allowing you to submit once all required information is included.

     

    Please be aware that we cannot begin to deal with your claim until we are in receipt of all required documents. Any costs associated with obtaining estimates must be met by you and will not form part of your claim.

     

    Please note that if you delay reporting a claim to us without good reason, and that delay causes an adverse and prejudicial effect to us, then we may decline to accept your claim.

     

    We ask that you do not replace or repair your bicycle or any of the damaged parts without our authorisation or agreement.

     

    You will be asked to supply evidence to support your claim, including but not limited to; evidence of ownership, evidence of damage, crime reference numbers, evidence – including the key - of the approved lock for your bicycle.

     

    Every claim will require a completed and accepted claim form. Before submitting this claim form, you must carefully check the answers and any supporting documentary evidence you have given.

     

    All relevant questions must be answered. Please provide as much detail as possible about the incident, as this will help us process your claim as quickly as we can. 

     

    Privacy Policy: https://concordia.be/privacybeleid/

     

    * required information

  • Section 1 - Your details

  • Section 2 - Details of the incident

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  • Section 3 - Your Claim

  • What information do we need below?

    Theft - Describe how the theft occurred, where the bike was stolen from and how it was locked/secured at the time.

    Accidental damage - Describe the damage that has occurred and who assessed it.

    Vandalism - Describe the damage that has occurred and who assessed it.

    Event fees - Detail the non-refundable fee which has already been paid by you for a road/circuit race in which you were due to participate, which you're no longer able to attend as a direct result of a cause which was entirely beyond your control. We will require receipts, please upload these.

  • *For Theft and Vandalism claims only

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  • Section 4 - What items are you claiming for?

    Please list each item included in the claim and confirm that evidence of ownership/damage is supplied.

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  • Section 5 - Additional information and checklist

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  • We may not be able to process your claim without suitable evidence, so please use this checklist to ensure that you have provided evidence for all relevant sections of your claim.

  • Declaration

  • I declare that the information contained in this claim form is true and accurate to the best of my knowledge and I have not withheld, exaggerated or provided any false information connected with this claim.

    I accept that any information provided to you will be processed by you and your agents in compliance with the provisions of the Data Protection Act 2018, for the purpose of providing insurance and handling claims, if any, which may necessitate providing such information to third parties.

    I understand that Bikmo have the right to take and keep possession of any item which is the subject of a claim made by me and to treat these items as salvage and to dispose of them in any way they deem appropriate. Any proceeds from such salvage belong to Bikmo and will be used by them to offset the amount of any claim payments.

  • When returning this claim form electronically, I understand that ticking the acceptance and submitting the claim confirms acceptance of the declaration.

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