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Motor Accident Claim Form

Important Note: Please make sure that the information provided is clear and complete as possible.nnThis form should be completed by the policyholder. Please enclose a copy of your licence with this claim form.

Before filling in this form, please ensure you have copies of the following for upload:

Notice relating to Storm Éowyn 

As property owners and employees return to properties over the course of the weekend, following the storm and the extreme weather, inevitably some damage will have been experienced across the country. Where possible efforts should be made to make safe affected areas or indeed to close off affected areas or sites. In the event of small damage incidents, please note or retain any materials relevant to the incident or damage and secure the property where possible. In all case only take such actions where it is safe to do so.

In the event of serious damage or where emergency assistance is required, please contact one of the following emergency contacts who will liaise with you.

Jacinta Gill on 086 8555028

Maria Carroll 087 7457674

Notifications of loss and claims may be made during regular business hours on Monday.