Frank Pickles

1Policy Holder Details

2Caravan Details

3Circumstances

4Declaration

Is the caravan subject to hire purchase?

Yes

If YES, please provide details:

Is the caravan on a fixed site?

Yes

Is the caravan currently in storage?*

Yes

How much is your daily storage rate (GBP)*

Provide photos if available

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

Was the caravan being towed by a motor vehicle?

Yes

If 'YES', please provide name/address of driver of vehicle and the registration number.

Was the caravan loaned / hired to the driver of the vehicle?

Yes

Where can the caravan be inspected?

File Upload

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

Please provide photos of damage.
Please obtain and provide an estimate for the repair of the caravan
Please provide a copy of the invoice
Please provide a copy of your CRiS document if available.

Damaged property should be protected from further deterioration but not disposed of without prior reference to the Claims Administrator.

Please provide a copy of the invoice and cris document if available:

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

Please upload pictures of damaged locks or items left at the scene:

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

Please give details of cause of loss/damage*

List below items of personal effects/ equipment loss/ damaged

Item

Details of cause of loss

Extent of damage

Owner of item

From whom purchased

Date of purchase

Cost/ Value (£)

Amount Claimed (£)

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

I / We 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.

In order to submit your claim, you MUST provide a photo of your signature*

Drop files here or

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

Simply take a photograph of your signature on a piece of paper and uploads it here.

Confirmation*

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

Dated

GDPR*

I consent to have this website store my submitted information so they can respond to my inquiry.

I have read and agree to the Terms and Conditions and Privacy Policy.

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General Enquiry

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