Get Avivabroker Form

The Avivabroker Form is essential for reporting motor vehicle accidents and processing related claims. Completing this form accurately ensures that your information is recorded correctly for insurance purposes, providing a clear record of the incident.

Follow the steps to complete the Avivabroker Form online.

1. Press the ‘Get Form’ button to access the Avivabroker Form and open it in your preferred editor.
2. Fill in Section 1 regarding the insured: Enter the policy or certificate number, full name, address including the postcode, phone numbers (home and business), occupation, and indicate if registered for VAT.
3. In Section 2, complete the driver’s details. Provide the full name, address, date of birth, license particulars, and any relevant driving history, including convictions or physical impairments that might affect driving.
4. Section 3 focuses on the vehicle information. Enter the vehicle's make, model, color, registration number, year of manufacture, and mileage at the date of the accident. Specify ownership details and usage purposes.
5. In Section 4, determine the claims preferences for damage to your vehicle and indicate if it is mobile. Provide the current location and whether it is at an approved repairer.
6. Section 5 asks for details of other parties involved, including name, address, and insurance information.
7. Fill out Section 6 with information regarding injured persons, detailing names, ages, and the nature of injuries. Indicate helmet or seat belt usage.
8. Section 7 requires you to specify the accident details. Include the date, time, location, applicable speed limit, weather conditions, and witness information.
9. Finally, complete Section 8 by signing and dating the declaration to affirm the information is true. After completing the form, save your changes, then download, print, or share it as necessary.

Complete your documents online today for a smooth filing process.