Motor Vehicle Claims

Motor Vehicle claims Notification

Insurer / Company

Your Details

Your Name*

Email address*

Your Mobile*

Policy Type

Policy Number

Vehicle Details

Make of Vehicle

Registration Number*

Model & Year

Engine Size (Cubic Capacity/Litres)

Incident Details

Date*

Time*

Where did it happen*

Name of Person Driving

Police Officer / Station

Describe the Incident

Describe the Damage to your Vehicle

Where can the vehicle be seen

Was it You or Your Driver's fault

Yes

Name of Injured Persons

Name of Witnesses

Uploads

Photos (one should include Registration Number(s))*

Documents (eg. licence, estimates, etc.)*

Do you hold more than one policy for this incident?

Yes

Were third parties involved?

Yes

Third Party 1 Details

Driver of Vehicle

Make of Vehicle*

Phone Number

Registration Number

Insurer

Licence Number

Date of Issued

Description of Damage

Add Third Party

Third Party 2 Details

Driver of Vehicle

Make of Vehicle*

Phone Number

Registration Number

Insurer

Licence Number

Date of Issued

Description of Damage

Third Party 3 Details

Driver of Vehicle

Make of Vehicle*

Phone Number

Registration Number

Insurer

Licence Number

Date of Issued

Description of Damage

Third Party 4 Details

Driver of Vehicle

Make of Vehicle*

Phone Number

Registration Number

Insurer

Licence Number

Date of Issued

Description of Damage

Third Party 5 Details

Driver of Vehicle

Make of Vehicle*

Phone Number

Registration Number

Insurer

Licence Number

Date of Issued

Description of Damage

This field should be left blank

Contact Us

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B16 2nd Lane, Dansoman
Accra - Ghana

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0307025030

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info@theinsurepeople.com

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Motor Vehicle Claims