Get Execuline Claim Forms

Filling out the Execuline Claim Forms online can streamline the process of reporting a motor accident. This guide provides clear, step-by-step instructions on how to accurately complete each section, ensuring that you submit all required information promptly.

Follow the steps to complete your Execuline Claim Forms online.

1. Press the ‘Get Form’ button to obtain the form and open it in the editing environment.
2. Begin by entering the insured and broker details, including the policy number, broker name, insured person's name, ID number, occupation, and contact information.
3. Provide the vehicle information by filling out the make, model, year, kilometers completed, registration number, and the registered owner's details.
4. Indicate if the vehicle is subject to a hire purchase, credit, or leasing agreement. If yes, include the finance company name and account number, along with the company's physical address.
5. Fill in the driver's details, including their full name, ID number, address, contact number, and driver's license information.
6. Specify the regular driver of the vehicle by selecting the appropriate option: insured, partner, or other. If 'other', provide details.
7. State the reason the vehicle was being used at the time of the accident and confirm if the driver was operating the vehicle with permission.
8. Indicate if the driver was in your employ and if they have their own motor insurance, providing company and policy number if applicable.
9. List any injuries sustained by persons in the insured vehicle and their hospital details if applicable.
10. Document information on third-party injuries, including names and details of injuries, along with any clinical information.
11. Provide details related to any third-party vehicle or property damage, ensuring to fill out all required sections for recovery purposes.
12. Note witness information, including their name, address, contact details, and whether they were a passenger in the vehicle.
13. Detail the accident, specifying the area of damage to your vehicle and any estimates for repairs. Include the name of the repairer and their contact information.
14. Complete the accident details, including date, time, the physical address where the accident occurred, and the conditions at the time.
15. Describe the full details of the accident, including any necessary sketches that illustrate the point of impact and direction of travel.
16. Sign the declaration section to confirm the truth of the information provided, noting the date of completion.
17. Upon final review, save your changes. You may also choose to download, print, or share the completed form.

Complete your Execuline Claim Forms online today to ensure a smooth claims process.