19/04/2021
Unknown
Edit
Remove
Claim
What kind of incident was it?
- Please Select -
Accident
Theft
Windscreen
Fire Damage
Vandalism
This field is required
Were you at fault?
Yes
No
When did this incident happen?
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2021
2020
2019
2018
2017
2016
This field is required
Did it affect your No Claims Bonus, or if your bonus is protected, did you lose a 'life' on the protection?
Yes
No
This field is required
Was a claim made against the proposer's policy?
Yes
No
This field is required
Is this claim pending?
Yes
No
This field is required
Do you know the total claims costs?
Yes
No
How much did the claim cost?
Please enter a cost greater than zero.
