Please read the list below before returning your Accident Report by EQl2Wvp


									                  Accident liability claim form
Please read these notes before completing and returning the enclosed liability form
and return to the address below. Please return your form and any enclosures (see
below) as soon as possible, retaining a copy for your records.

1   £50.00 excess applies to this policy on the minded children’s property (items
    needed for childminding activities) clothes, buggies, toys and third party
    property. The £50.00 will be deducted from the payment cheque to the claimant.

2    Please enclose a copy of your Ofsted/CSSIW Registration Certificate. Please
     do not send the original.

3    Please ensure you include your NCMA membership number which can be
     found on your membership card.

4    Ensure that you state clearly the total amount you wish to claim.
     4.a Please attach a letter from the third party (the person who is holding
         you responsible for the damage or incident), stating clearly that they are
         holding you responsible.
     4.b If third party property is damaged, please enclose an estimate, receipt or
         account from a reputable repairer.

5    The total life of the insurance policy is 21 years and 4 months to enable a child
     to make a claim against the policy in the future.

6    Please note:
     There is no cover under the policy for loss of, or damage to, the childminder’s
     own property or in the custody and control of the childminder.

     There is also no cover under the policy for damage to another motor vehicle
     involving your own vehicle.

     Please check that your other relevant insurance policies cover you for your
     childminding activities.

You may find it useful to keep copies for your files in case the paperwork is lost in the

NCMA Membership Services
Royal Court
81 Tweedy Road
Kent BR1 1TG
                          Accident liability report form
Name of Childminder
Public Liability Insurance Policy No:            RTT161353

Address, including postcode

Telephone no

Email address

NCMA membership no

Details of Incident:




Child’s full name

Date of birth                            Child’s age at time of accident

Child’s address, including postcode

Parent(s) full name

Please describe the circumstances
Please continue on the back if you print this document to complete it, or attach a sketch as necessary.

Has a claim been made against you?                   Yes

If yes, please enclose copies of any correspondence received.

The total life of the insurance policy is 21 years and 4 months to enable a child to
make a claim against the policy in the future.

No admission of liability, or payment or promise of payment should be made

Signed……………………………………………....                                      Date……………………….…….

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