01623 650750

Opening Hours 9am-5pm Monday-Friday

01623 663105

Opening Hours 9am-5pm Monday-Friday

01623 663101

Opening Hours 9am-5pm Monday-Friday

claims@aips.co.uk 01623 663110

Opening Hours 9am-5pm Monday-Friday

Motor Accident Report Form

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Step 1 -The Policy Holder

 Yes No

Step 2 - The Driver (or person last in charge of the vehicle)

 Yes No
 Yes No

 Yes No
 Yes No
                                            Yes No
 Yes No

Step 3 -The Vehicle

The Accident:

                                          
 Yes No
 Yes No

 Yes No
 Yes No

Step 4 -Repairing Garage

If own repairer upload repair estimate:

Police Details

Step 5 -Third Party Details

 Yes No

Step 6 -Witness Details

 Yes No

Any Other Supporting Information

Statement: The above answers to our questions will be the basis the Insurers will use for consideration of your claim. You must ensure that all information is true and correct to the best of your knowledge and belief and that all material facts have been disclosed. A material fact is one that is likely to influence your Insurers decision regarding cover on your policy. If you are in any doubt as to whether a fact is material, you must disclose it.
I confirm I have read and understood this statement  Yes I Understand

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