Submit a ticket
Greenworld Admin Portal > Submission Portal > Submit a ticket
 

Use this form to submit a support request. Required fields are marked with *

Name: *
Email: *

Priority: *

Salvage Payment to: *
Department / Branch:
Incident Date:
Claimed/Insured Amount:
Policy Number:
Insured Name: *
Insured Cellphone Numbers:
Insured ( H/W ) Numbers:
Insured Email Address:
Insured Address:
Insured Area: *
Repairer/Broker/Other:
Repairer/BK Name:
Repairer/BK Contact Numbers:
Repairer/BK Address:
Repairer/BK Area:
Repairer Job Card Number:
Repairer/BK Email Address:
Payment Due ( GWR Use ):

Claim Number: *
Message: *

Attachments:



File upload limits

SPAM Prevention: * Type the number you see in the picture below.
 
Security image Reload image
 

Before submitting please make sure of the following
  • All necessary information has been filled out.
  • All information is correct and error-free.
We have:
  • 107.22.52.86 recorded as your IP Address
  • recorded the time of your submission

 

 
Powered by Help Desk Software HESK, brought to you by SysAid