Report an accident
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Report your accident
Report your accident by phone or with our online form and get immediate help
24/7 accident helpline:
0800 179 9005
This line is dedicated to accident assistance ONLY and is not a general enquiries line
The form below gives you the power to tell us about what's happened in your own words.
Don't worry if there are some boxes you leave blank; just tell us what you can.
Your first name:
Address line 1:
Address line 2:
About your vehicle:
Make & model:
Date, time and location of the accident:
Date & time of the accident:
Location of the accident:
About the damage to your vehicle:
Is your vehicle damaged?
If yes, please describe the damage to your vehicle:
About any physical injuries to yourself and/or your passenger(s):
Any physical injuries to yourself and/or anyone else?
If yes, please describe the injuries:
About the at-fault party:
Is the at-fault party identified?
Is the at-fault party insured?
If yes, at-fault party's name:
If yes, at-fault party's insurer:
At-fault party's other details: the make & model of the vehicle he/she was driving, their vehicle's reg plate number, their address, etc - whatever you have about the third party, please enter this information below:
About witnesses to the accident, if there were any:
Any witness(es) to the accident?
If yes, please tell us about the witness(es) below:
1st witness's name:
2nd witness's name:
Your description of what happened:
Please describe as much as you can about what happened - feel free to write as much as you like:
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Assist Protect Ltd.
Where the term 'cover' is used in this site, it is as an umbrella term denoting the benefits and services included in our membership package and not to denote a policy of insurance.
Assist Protect Ltd is a company limited by shares and the registered office is at Mercia Place, 2 Main Street, Repton, Derbyshire, United Kingdom, DE65 6EZ Company No. 7184256.
© Assist Protect Limited. All rights reserved.
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