Mobility Scooter 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

Address & Contact Details

About Your Claim

Provide details of the road/street name and a postcode, where possible
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)

Claimed Items

List individual items and their replacement cost on a separate line
For example home insurance or manufacturer warranty
Select no if incident was not caused by a third party

Declaration