Report your accident
Tell us about your accident and get the help you need
You can call us now on our Member Helpline or use our Report Form below:
24/7 accident helpline:
☎ 0800 179 9001
This line is dedicated to accident assistance ONLY and is not a general enquiries line
If you have an enquiry, please click here
Report Form
Don't worry if there are some boxes you leave blank; just tell us what you can.
About you
First name:
Surname:
Email:
Mobile tel:
Home tel:
Date of birth:
Your address
Line1:
Line 2:
Town:
County:
Post code:
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About your vehicle:
Make & model:
Registration:
About your own insurance:
Your insurer:
Policy number:
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Date, time & location of the accident:
Date & time:
Location:
Who is at fault for the accident?
Is there a third party involved?
Yes/No...
Yes
No
Who do you think is at fault?
Please select...
100% my own fault
100% Third Party's fault
Mixed fault/not sure
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About the Third Party (if applicable):
Is the Third Party identified?
Yes/No...
Yes
No
If yes, Third Party's name:
Third Party's email:
Third Party's contact tel:
Third Party's address & postcode:
Third Party's vehicle make:
Third Party's vehicle model:
Third Party's vehicle reg:
Is the Third Party insured?
Yes/No...
Yes
No
If yes, Third Party's insurer:
Has Third Party admitted liability?
Yes/No...
Yes
No
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About the damage to your vehicle:
Is your vehicle damaged?
Yes/No...
Yes
No
If yes, please describe the damage to your vehicle:
About any injuries to you and/or your passenger(s):
Are there any injuries?
Yes/No...
Yes
No
If yes, please describe the injuries and who has suffered them:
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About any witnesses to the accident:
Were there any witnesses?
Yes/No...
Yes
No
If yes, please enter the name(s) and contact details of any witnesses:
Police and ambulance:
Were the police involved?
Yes/No...
Yes
No
Was an ambulance called?
Yes/No...
Yes
No
If yes to either question, please add any details below:
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Your description of what happened: