Caravan Insurance

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1Holder Details

2Caravan Details

3Claim Details

4Claim Details

5Claim Details

6Declaration

Full Name of Insured*

First

Your First and Last Name as registered to the Policy

Last

Address*

Address Line 1

The address to which your Policy or Warranty is registered

Address Line 2 City Postcode

Email Address*

A current e mail address by which we can contact you

Mobile*

Telephone Number and Area Code

Policy Number

The Unique Reference Number shown on your Policy Schedule

Date of incident*

The date the incident occurred

DD slash MM slash YYYY

Caravan Make*

The vehicle Make e.g. Bailey

Caravan Model*

The vehicle Model e.g. Phoenix

Claim Type*

What has caused the damage / loss to your caravan?

Accidental Damage

Theft

Fire

Other

Claim Type Description*

The vehicle Model e.g. Phoenix

Claiming for total loss or repair?*

What has caused the damage / loss to your caravan?

Total loss

Repair

When was the caravan last checked?*

DD slash MM slash YYYY

At the time of the incident where was your caravan?*

At Home

In Storage

In Use

Other

Incident Address*

Street Address City ZIP / Postal Code

Was the caravan being towed by a motor vehicle?

Yes

Was the caravan being towed by the policy holder?

Yes

Who was towing the caravan?*

Was there a third party involved?*

Yes

Third Party Details*

Name,

Address,

Vehicle Registration,

Insurance Company & Policy Number

Please give details of how the accident occurred.*

Describe the events that took place

Provide photos*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide a copy of the invoice and CRiS documentation*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide a repair estimate if possible

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please give details of how the theft occurred.*

Describe the events that took place

What security did you have in place to prevent the theft?*

Describe the events that took place

Police station(s) at which the theft was reported:*

Date,

Police Crime Reference No,

Station

Please provide a copy of the invoice and CRiS documentation*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide pictures of damaged locks or items left at the scene

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide CCTV footage

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide photos of the site showing the suspected exit*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide a repair estimate if possible

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

List below items of personal effects/ equipment loss/ damaged

Item

Extent of damage

Cost/ Value (£)

Please provide receipts for any contents items over £50

Drop files here or

Accepted file types: jpg, jpeg, gif, png, Max. file size: 8 MB, Max. files: 10.

Please give details of how the fire occurred.*

Describe the events that took place

Was the Fire Brigade in attendance?*

Yes

Do you have a fire report number?*

Please provide Images and/ or CCTV footage*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide a copy of the invoice and CRiS documentation*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

Please provide a repair estimate if possible

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

List below items of personal effects/ equipment loss/ damaged

Item

Cost/ Value (£)

Please provide receipts for any content over £50

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 8 MB, Max. files: 10.

I / I declare that no material information has been withheld and that all statements on this form are true to the best of my / our knowledge and belief. Further the articles and property belong to the persons named and no other person has any interest. I / we understand that you may seek information from other insurers to check the answers I / we have provided, and I/we authorise the giving of such information for such purposes.

Full details of the claim must be submitted as soon as possible after the event and always within 14 days of the incident occuring. You must also provide us with all information and evidence, including written estimates and proof of ownership and value that we may request.

Is there any other information you wish to make us aware of?

Confirmation*

I hereby certify that all the information given in this form is truthful, accurate and complete.

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General Enquiry

Contact our customer services team via the contact us page

Sales Team

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