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Ingenium Dynamics
Third Party Claims
Complete this form and contact our team
Your Details
Your Vehicle
Step
1
of 2
First Name:
Please enter your first name
Last Name:
Please enter your last name
Home Address Line 1:
Please enter your home address
Town / City:
Please enter your town / city
Post Code:
Please enter your postcode
Contact Number:
Please enter your contact number
Email:
Please enter your email
Date of Birth:
Please enter your date of birth
Are you VAT Registered?
Yes
No
Next
Make:
Please enter a make of vehicle
Model:
Please enter the vehicle model
Registration:
Please enter a registration
Who is it insured with?
Select your insurer
1st Central
Acromas
Admiral
Ageas
AIG
Allianz
Aviva
AXA
Bell
Churchill
Covea
Diamond
Direct Line
Elephant
Esure
Hastings
LV
Markerstudy
NFU Mutual
QBE
RSA
Sabre Insurance
Swiftcover
Tesco
Tradex
Zurich
Please select your insurance provider
Are you the registered keeper?
Yes
No
Is your vehicle subject to a finance agreement?
Yes
No
Accident Details
Is your vehicle currently roadworthy?
Yes
No
Do you require a replacement vehicle for the duration of the repair?
Yes
No
Have you already been provided with a replacement vehicle?
Yes
No
Where is the vehicle now?
Please enter where the vehicle is now
Describe the damage to your vehicle.
Please describe any damages
Were you or any occupants of the vehicle injured in the incident? If yes, add details.
Please enter information, otherwise enter n/a
Add photos of your vehicle showing the damage and registation plate if possible.
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