Business Insurance · Personal Insurance · Wakefield, West Yorkshire · Make a Claim

To make a claim call our dedicated claims team on 01924 871 111, selecting option 5 for claims.

Or alternatively, complete the claims form below which will be sent directly to our team.

Step 1 of 3

Policyholder / Company Name*

Your Details as the Driver & Vehicle driven at the time

Name*

Email*

Date of Birth*

Date Driver Passed their Test

Does the Driver Have any Medical Conditions

Address*

Street Address Town / City Postcode

Vehicle Make & Model*

Vehicle Registration*

Any injuries sustained / details of injuries

Incident Details

Date*

Time*

Speed (MPH)

Location including road name and postcode*

Circumstances*

Liability admitted?*

Yes

Accident your fault?*

Yes

Did the police attend?*

Yes

Police Officers name / PC Number / Station

Weather at the time*

Wet

Dry

Damp

Road Conditions

Damage sustained to vehicle

Upload supporting image of damage

Max. file size: 512 MB.

Third Party Details

Name of Third Party Driver

Address

Street Address City / Town Postcode

Phone

Vehicle Make & Model

Vehicle Registration

Name of Insurer

Number of Passengers

Please enter a number less than or equal to 10.

Any Injuries sustained / details of injuries

Damage sustained to vehicle

Upload supporting image of damage

Max. file size: 512 MB.

Make a Claim

Your Details as the Driver & Vehicle driven at the time

Incident Details

Third Party Details

Sectors

Policies

We are social: