MCFP Live-Demo

PRIVATE - Risk assessment high-value household contents - security description

Continue later? Just copy the link here:

Form helper

Helps with Filling Out

If you activate the voluntary AI assistance, I will check when you click “Next” whether important information is missing or unclear.

Activate AI Help (optional)

Your question and the information from the current form page are sent via My Custom Form to OpenAI. Passwords, signatures, and file contents are not sent. Please do not enter particularly sensitive information in questions. You can disable the AI here at any time and complete the form without AI.

Personal Data Fully Known – Data Entry Not Required

Personal Data Fully Known

Title, academic degree

Name

First name

Address

ZIP code City

Date of Birth

Birth Name

Place of Birth

Nationality

Occupation

Professional status

Location of the house

within a built-up area

outside built-up area

House type

Single-family house

Multi-family house

Location of the rooms to be insured

Basement floor

Ground floor

Upper floor

Floor (please specify)

Location of the rooms to be insured – floor (specify)

Material of doors

Metal

Solid Wood

andere

Material of doors – other

Are there glass inserts in the doors?

yes

Size of Glass Inserts – Width (cm)

Size of Glass Inserts – Height (cm)

Securing glass inserts

grids screwed on the inside

shatter-resistant glazing

Material of door frames

Metal

Wood

andere

Material of door frames – other

Closure by cylinder locks

yes

Cylinder lock flush with security fitting or screwed from inside

yes

Are additional supplementary locks installed?

yes

Additional supplementary locks – on the following doors

Are concealed door hinges installed?

yes

Full glass / sliding / terrace or balcony doors – located more than 2.5 m above ground level and not accessible via extensions, trees, or similar?

yes

Securing full glass / sliding / patio or balcony doors

lockable lever locks

shatter-resistant glazing

grids screwed on the inside

andere

Securing full glass / sliding / patio or balcony doors – other

Skylights and light domes present?

yes

Securing skylights and light domes

lockable lever locks

shatter-resistant glazing

grids screwed on the inside

andere

Securing skylights and light domes – other

Are windows on the ground floor or up to 2.5 m above ground level present?

yes

Securing Windows on the Ground Floor or up to 2.5 m Above Ground Level

lockable window handles

shatter-resistant glazing

grids screwed on the inside

Metal/wooden shutters

Plastic Roller Shutters

Roller shutter security

andere

Securing ground floor windows – other

Basement windows present?

yes

Securing basement windows

metal grids anchored in masonry

steel perforated plates or padlocks screwed on the inside

andere

Securing basement windows – other

Are the associated grates secured?

yes

Mehrwandiger Stahlschrank (> 200 kg) oder eingemauerter Tresor mit mehrwandiger Tür vorhanden?

yes

VdS-approved burglar alarm system present?

yes

Intrusion Alarm System – Manufacturer

Intrusion Alarm System – System

Intrusion Alarm System – Reporting

Local

Security Institute

Police Emergency Number

Intrusion Alarm System – Attached Documents

Certificate (VdS 2170)

Installation Protocol

Maintenance contract

sonstiges

Intrusion Alarm System – Other Documents

Other security measures (e.g., security personnel, guard dogs) present?

yes

Other security measures – description

Hinweis: i.d.R. werden Kosten (z.B. Hotelkosten) auf die Versicherungssumme angerechnet und müssen daher ggf. zusätzlich berücksichtigt werden!

Total valuables in €

Share of valuables in the insured amount in %

Davon entfallen auf:

Cash and Amounts Loaded on Money Cards in €

Documents including savings books and other securities in €

Jewelry, gemstones, pearls, stamps, coins, medals, gold, platinum, etc. in €

Furs, hand-knotted carpets and gobelins, art objects, etc. in €

Antiques (items over 100 years old) in €

Individual values over €10,000 – description

Individual values – expert reports attached

Expert reports attached

Additional special and unusual risk situations present?

yes

Description of special and unusual risk situations

Other notes, remarks

Bei den Fragen handelt es sich um Fragen über gefahrerhebliche Umstände. Unvollständige und unrichtige Angaben zu den gefahrerheblichen Umständen berechtigen den Versicherer, im Falle der vorsätzlichen oder grob fahrlässigen Verletzung der Anzeigepflicht, vom Versicherungsvertrag zurückzutreten. Wird die Anzeigepflicht vorsätzlich oder grob fahrlässig verletzt, hat der Versicherer das Recht, den Vertrag innerhalb eines Monats ab Kenntnis von der Anzeigepflichtverletzung unter Einhaltung einer Frist von einem Monat zu kündigen. Diese Daten werden ggf. zur weiteren Verarbeitung (z.B. Angebotserstellung, Schadenbearbeitung etc.), wie in der "Einwilligungserklärung zur Datenverarbeitung" beschrieben, an Versicherer und Dienstleister weitergeleitet.

Date (Signing)

Customer's signature

Upload signature as image Signature required