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Bicycle insurance Adapted cycles insurance E-bike insurance E-cargo bike insurance Cycle Rescue Cycle hire

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Breakdown

Products

Breakdown Cover Single-trip European Breakdown Fleet Breakdown Cover Offset your driving

Existing customers

Broken down?Manage your policy Policy Wording

Useful information

Driving and the law The ETA Guide to Driving in France Driving in the rest of Europe

Cycle

Products

Bicycle insurance E-bike insurance E-cargo bike insurance

Existing customers

Make a claim Manage your policy Policy wording

Useful information

Proof of ownership Finding my frame number Lock requirements Cycle storage requirements Cycling and the law

Mobility

Products

Mobility Scooter Insurance Mobility Scooter Breakdown Offset your carbon

Existing customers

Broken down?Make a claim Manage your policy Policy wording

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Cycle Insurance – Claim Form

We like to settle claims quickly and justly. Claims can be settled in a few days or take a number of months. Most delays are caused by claimants not completing this form or not providing the necessary documentation.

About You

ETA number*

First name*

Last name*

Address & Contact Details

House/flat number and street address*

Town*

Postal code*

Email*

Phone number*

About Your Claim

Incident type*

Date you left or last saw your bicycle*

Time you left or last saw your bicycle*

Date you returned to your bicycle or discovered theft/damage*

Time you returned to your cycle or discovered theft/damage*

Location of incident*Provide details of the road/street name and a postcode, where possible

About your claim in detail*State circumstance in which loss/damage occurred and exact details (if theft, please include how entry was obtained – which doors/windows were forced, if relevant. Please also provide details of the make and model of lock used to secure the bicycle and how the bicycle was locked)

Was crime reported to the police*

Yes
No
N/A

Reported to which police station*

Crime reference number*

Claimed Items

Make & model of bicycle*(Please include the frame number of the bicycle if possible)

Estimated value of repair or replacementList individual items and their replacement cost on a separate line

Is the bicycle covered by any other insurance policy?*For example home insurance or manufacturer warranty

Yes
No

Was a third party involved?*

Yes
No

Were you injured?*Select no if incident was not caused by a third party

Yes
No

Declaration

I confirm that the information entered on this form is true and accurate to the best of my knowledge*

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ETA Services Ltd is registered in England (3314244) and is authorised and regulated by the Financial Conduct Authority – number 313965.Registered office: 68 High Street, Weybridge KT13 8BL

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