Lodge a Claim

MOTOR VEHICLE ACCIDENT CLAIM FORM

Completion of this form is not an indication that we accept any liability.
Please note this is an initial assessment, once you have submitted your details a TIC representative will contact to you obtain further details.

1. Insured Details




2. Vehicle Details





 

3. Driver Details

The Driver or Person last in charge of your vehicle before the accident/damage/loss occurred.






4. Description of Accident



5. Description of Damage to vehicle


6. Other