Step 1 of 8

What happened?

Pick the option that best describes the incident. We'll only ask the questions that matter.

Accident / collision

Impact with another vehicle, object, or property.

Theft

Vehicle or contents stolen, attempted theft, break-in.

Damage only

Vandalism, weather damage, or unknown cause.

Date of incident * Time of incident *

Vehicle registration *

Step 2 of 8

Describe the incident

Be factual. Sketch the scene if it helps — diagrams reduce back-and-forth later.

Brief description of what happened *

Just before the incident * Immediately after *

Sketch the scene (optional)

CCTV or dashcam footage? *

Yes No

Photos of damage? *

Yes No

Police caution / notice issued? *

Yes No

Details of the caution / notice *

Step 3 of 8

Circumstances

A few specifics about the conditions and context.

Accident location *

Weather conditions * Road conditions *

Speed prior to incident (mph) * Speed at impact (mph) *

Do you believe you were responsible? *

Yes No Unsure

If not, why? *

Were there passengers in your vehicle? *

Yes No

Passenger details & any injuries *

Where was the vehicle parked? *

Has the vehicle been recovered? *

Yes No

When was it recovered? *

Claiming for personal effects? *

Yes No

List the items *

Where was the damage discovered? * Suspected cause *

Step 4 of 8

Vehicle details

Identify the vehicle and how it was being used.

Make * Model *

Purpose of use at time of incident *

Trailer being towed? *

Yes No

Goods being carried? *

Yes No

Trailer damage? * What goods? * Where is the vehicle kept overnight? *

Step 5 of 8

Driver details

Tell us about who was driving the van at the time.

Driver name * Date of birth *

Driver address *

Driver postcode * Driver telephone *

Years as UK resident * Occupation *

Licence type *

Date passed test *

Motor claims in last 3 years? *

Yes No

Prior claim details * DVLA-reported medical conditions *

Any motoring convictions or impending prosecutions? *

Yes No

Conviction details *

Step 6 of 8

Damage to your vehicle

Help us figure out repair logistics. Approved repairers can start immediately if mobile.

Describe the damage *

Is the vehicle immobile? *

Yes No

Where is the vehicle now? *

Claiming for personal effects? *

Yes No

List the items *

Add photos or dashcam clips Tap to take photos or choose multiple from gallery · max 25MB each

Step 7 of 8

Third party details

Details of the other party involved. Type 'N/A' for any line that genuinely doesn't apply.

Other party name * Other party phone *

Driver description * Vehicle make, model, colour, registration * Their insurer (name, address, policy number) * Damage to their vehicle *

Passengers in their vehicle? *

Yes No

Damage to other property? *

Yes No

Any injuries? *

Yes No

Passenger names & contact details * Other property damage details * Injury details (and hospital if applicable) *

Step 8 of 8

Witnesses, services & review

Almost there. One last look before submitting.

Emergency services present? * (select all that apply)

Police Ambulance Fire None

Service reference numbers / station details *

Were there any witnesses? *

Yes No

Witness names, addresses & phone numbers *

Your submission summary

Declaration

I declare that the information given in this form is true and correct to the best of my knowledge. I authorise the relevant insurer to deal with this claim within the terms of the policy and admit liability on my behalf if appropriate. I understand that the insurer may seek information from other insurers to verify these answers.

Type your full name to sign * I confirm the information above is accurate and I have authority to submit this claim.

Your submission summary

Declaration

Claim submitted