Frank Pickles

1Holder Details

2Caravan Details

3Claim Details

4Claim Details

5Claim Details

6Declaration

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

Provide photos*

Drop files here or

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

Please provide CCTV footage

Drop files here or

Accepted file types: jpg, jpeg, gif, png, 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, 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, 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.

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, 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, 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, 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, Max. file size: 8 MB, Max. files: 10.

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 occurring. 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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