Fill in the claim form

Being involved in a collision is annoying enough. When should you fill in a claim form or not, and what information should you fill in and tick? It is important for the insurance company that you fill in the form as completely as possible in order to settle your claim correctly. It would be a pity if your claim was rejected because the form was not filled in correctly.

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When to fill in a claim form?

If you have had a collision in which another party was involved, a claim form must always be completed by both parties. The claim form consists of an explanation, an original claim form and a reprint of this form. You and the other party fill in the original form. This automatically prints the information you fill in on the claim form which is attached to it. Are you using a printed claim form? Then you and the other party will have to fill it in twice. A printed claim form does not push through. It is important that both parties have a fully completed claim form.

In principle, a claim form is not necessary for window damage, storm damage, fire damage, hail damage, break-in damage, theft of the vehicle and collisions in which no other party was involved.

How do I fill in a claim form?

The claim form has a front and a back. You must fill in the front together with the other party. You can also fill in the back of the form at home. These are mainly your personal details. Below we will explain exactly how you should fill in the form.

Fill in the front

On the front of the claim form you will see the numbers 1 to 15. For each number there is information that you and the other party must fill in. Go through all the steps calmly and fill in everything as completely as possible.

Also clearly discuss with the other party who fills in their details under vehicle A, and who under vehicle B. At number 6, the details of the policyholder are requested. Number 9 asks for the driver's details. For number 9, you should always fill in the details of the driver at the time of the collision. Was your vehicle parked at the time of the collision and no one was present? Then you cannot fill in the driver's details.

In the middle of the form you will see number 12, indicated as "reason". Here you can tick the appropriate box or boxes. This makes it much clearer for the insurance company to assess how the collision happened. At the bottom of the form, at number 14, marked "my comments", both parties can give a brief explanation.

Once all the information has been completed and both parties agree with what is written on the form, the form should be signed by both persons. After signing, the original can be torn off from the reprint so that both parties involved have their own form.

Fill in the back

The completion of the back of the claim form is often forgotten by the insured. Yet it is very important for the insurance company that the reverse side is completed. You can fill in the reverse side at home. You do not need the other party to do this. By filling in the reverse side of the form, it makes the claim form your own.

A lot of information is requested on the back of the claim form, but not everything is equally important. The most important eight points to be filled in are the following:

  1. Policyholder
  2. Driver
  3. Damage to your motor vehicle
  4. Police
  5. Victims
  6. Circumstances of occurrence
  7. Liability
  8. Date and signature

Please make sure that you fill in all the information covered by these points. For example: The data that fall under policyholder are name, account number, profession, employment/self-employment and right to deduct VAT.

Play video fill in the claim form

What else do I need to consider when filling it in?

Finally, we will give you some tips that you can use if you are involved in a collision and have to fill in a collision form:

  1. If a discussion arises between you and the other party while filling in the claim form and you do not agree with what the other party says on the form, do NOT sign the form!
  2. Take photos of the damage to both vehicles.
  3. Take photos of the situation on site.
  4. Look for witnesses and note down full name and address details and a telephone number.
  5. Take a photo of your claim form (front and back). If the form does not arrive at the insurance company, you always have something in reserve.
  6. Once the front of the claim form has been signed by both parties, you are NOT allowed to make any changes to the form. If you do, your form will be invalid.

Who should fill in the claim form?

You must fill in the front of the claim form together with the other party. It is best to do this immediately after the accident, when everything is still fresh in your mind.

What to do after filling in the claim form?

Once you have completed the claim form, send it to the car insurance company. This can be done by post or e-mail. Check with your insurer where you should send the claim form. Nowadays you can also report the damage using a mobile app. Then you don't have to fill in the claim form at all, but you can answer the questions in the app. You can also add photos.


Fill in the claim form: download the claim form for free

Always keep a claim form in the car. In the unlikely event that something happens, you can settle this properly with the other party. On our website you can download an online claim form.

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  • i To calculate the premiums, we need the postal code of the main driver. In case of private use, the youngest driver must reside at the same address as the applicant. In case of business use you can fill in the postal code of the company.

How do we do it?

Last updated: 22-04-2022

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