Fill in the claim form

When to fill in a claim form?

If you have had a collision involving another party, a claim form should always be filled out by both parties. The claim form consists of an explanatory note, an original claim form and a carbon copy of this form. You fill out the original form with the other party. As a result, the information you fill out automatically prints on the claim form attached to it. Are you using a printed claim form? Then it will have to be filled out twice by you and the other party. This is because a printed claim form does not print through. It is important that both parties have a fully completed claim form.

Basically, for windshield damage, storm damage, fire damage, hail damage, burglary damage, theft of the vehicle and collisions that did not involve an opposing party, a claim form is not necessary.

How do I fill in a claim form?

The claim form has a front and a back. You fill out the front side together with the other party. You can also fill out the back side at home. These are mainly your personal details. Below we will briefly explain exactly how to fill out the form.

Fill in the front

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

Also clearly discuss with the opposing party who enters their information under vehicle A, and who enters their information under vehicle B. Number 6 asks for the policyholder's information. Number 9 asks for the driver's information. At number 9, you always enter 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 can't enter anything at driver.

In the middle of the form, you will see number 12, marked "attribution." Here you can check the box(es) that apply. This makes it a lot clearer for the insurance company to assess how the collision occurred. At the bottom of the form, at number 14, indicated as "my comments," both parties can add a brief explanation of their own.

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

Completing the back of the claim form is often forgotten by insureds. Yet it is very important for the insurance company that the back side is filled out. Filling out the back side can be done quietly at home. You do not need the other party for this. By filling out the back of the form, it makes the claim form become your form.

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

Remember to fill in all the information covered by these items? Example: The information that falls under policyholder are name, account number, occupation, employed/self-employed and right to deduct VAT.

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

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

1. If a discussion arises between you and the other party while filling out the claim form and you disagree with what the other party states on the form, DO NOT put your signature on 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 picture of your claim form (front and back). Should the form not arrive at the insurance company, you always have something in reserve.
6. Once the front of the claim form is signed by both parties, you may NOT change ANYTHING on the form. If you do then your form is invalid.

Who should fill in the claim form?

You should fill out the front of the claim form 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 completely filled out the claim form, send the form to the car insurance company. This can be done by mail or e-mail. Check with your insurer where to send the claim form. Nowadays you can also report the damage via a mobile app. Then you don't have to fill out the claim form at all, but answer the questions in the app. Moreover, you can then also add photos.

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

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