Generali Employee Benefits
Personal Data Breach - External Source: other
1. Identifier details
Company Name
This field is required.
Name
This field is required.
Surname
This field is required.
E-mail address
This field is required.
Please check the email address
Telephone number
This field is required.
2. Breach details
Cause of personal data breach
This field is required.
Date breach occurred
Date breach detected
This field is required.
Notification date
Eventual delay in notification
Nature of personal data
This field is required.
Name
Address
Date of birth
ID number/code
E-mail address
Health data
Insurance/claim details
Hobbies/interests
Professional information
Others (please specify)
Nature of personal data
Number of individuals impacted
Breach classification
This field is required.
Unauthorized disclosure of client/insured /claimant/employee personal data
loss or theft of GEB data storage device
intrusion attempt
malware
unauthorized access
Others (please specify)
Data breach details
This field is required.
Root cause
This field is required.
Human error
Process failure
Systems issue
Unknown
Others (please specify)
Infrastructure/Application impacted by the breach
3. Details concerning theft/loss (if applicable)
This report refers to a theft/loss
no
yes
4. Additional Information
Additional information
Captcha
Please complete the captcha to submit.
mandatory field
Please fill in the required fields before submitting the form