Accident Claim Form
Important Notes:
- Make sure that you give us all the details about your accident.
- Send us all quotations which you have recived for repairs.
- Be ready to give any information and documents that we may ask for.
- Page 1 to be completed by the member.
- Page 2,3 & 4 by the driver of the vehicle.
- Declaration on page 4 to be signed by the member and the driver.
- IF INSUFFICIENT SPACE please add additional sheets.
The issue of this Form on Receipt of Notice of an accident is no admission of liability and it is issued without prejudice.