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Windscreen Claim Form docx 2026

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4.2 out of 5

24 votes

The document is a Motor Accident Report Form used for filing claims with a general insurance company in Jamaica. It requires detailed information about the insured, vehicle, driver, and particulars of the accident. The form emphasizes the importance of honesty in providing information, stating that any false declarations may void the policy and forfeit the claim.

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Click ‘Get Form’ to open the Windscreen Claim Form in our platform's editor.
Begin by filling in the 'Particulars of Insured' section. Enter your name, home address, telephone number, business address, occupation, nationality, and age accurately.
Next, move to 'Particulars of Insurance.' Input the due date, policy number, type of cover (e.g., Private Car), insured value, last premium paid, and type of insurance (e.g., Comprehensive).
In the 'Particulars of Vehicle' section, provide details such as license number, make and year of the vehicle, whether it is left or right-hand drive, and its color.
Fill out the 'Particulars of Person Driving' with the driver's name, occupation, address, driver's license number and type, telephone number, date issued, tax office location, and classes of vehicles specified in the license.
Complete the 'Particulars of Accident' section by entering the date and time of the accident along with its location.
Finally, review your entries for accuracy. Sign where indicated as both insured and driver. Ensure you attach any required documents before submission.

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Versions	Form popularity	Fillable & printable
2021	4.2 Satisfied (24 Votes)
2015	4 Satisfied (33 Votes)

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