MOTORSPORT INSURANCE

Motorsport Insurance claim form

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PLEASE NOTE. You must report the incident likely to give rise to a claim within 48 hours of the finish of the insured event. You must also supply all of the documentation we ask for as soon as possible after the notification of the incident.

For our full claims reporting requirements please refer to your policy wording.

DRIVER DETAILS

Team name:

Driver’s name:

Address:

Postcode:

Contact email:

Contact number:

Policy number:

Preferred method of contact:

Phone

Post

ACCIDENT DETAILS

Date of accident:

Time of accident:

Circuit:

Name of circuit:

Was your driver hurt:

Yes

Did the driver receive medical attention?:

Yes

Will the driver be able to race within the next 14 days?:

Yes

The accident happened during:

Weather conditions/ Track surface:

Full details of accident:

CAR DETAILS

Type of formula/class:

If other please specifiy:

Parts damaged:

Currency:

Estimated damage:

LOCATION DETAILS

Please advise us of the current whereabouts of this vehicle in case we wish to carry out an inspection:

DECLARATION

By clicking “Submit” you declare that the above statements and particulars are true and complete to the best of your knowledge and belief, and that no material facts have been withheld, misrepresented or mis-stated