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MOTOR ACCIDENT REPORT CARD

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MOTOR ACCIDENT REPORT CARD Powered By Docstoc
					MOTOR ACCIDENT REPORT CARD

Complete as far as possible at the scene of accident

STAY CALM – DO NOT ADMIT LIABILITY

Please contact Frontline Road Assist on 0861 113 699 if you need to tow your
vehicle

     ACCIDENT DETAILS
     Date                    Time                             Place
     YOUR DETAILS                                          OTHER PARTY DETAILS
     Your Name                                             Name of driver
     Your ID No.                                           ID No.
     Vehicle Details                                       Address
     Reg. No.                                              Tel No.

                       Of position of vehicles, impact
     Take photos                                           Reg. No.
                       area of damage

                       Of scene of accident and            Name of owner
     Take photos
                       injuries sustained                  of vehicle

                       Please remember to keep one         Tel No. of
     Emergency Kit
                       in your vehicle                     owner


     NAME OF INJURED PERSONS                             INDEPENDENT WITNESSES
     1.                                                  Name
                                                         Tel No.
     2.                                                  Name
                                                         Tel No.
     3.                                                  Name
                                                         Tel No.


Report this accident to the SOUTH AFRICAN POLICE SERVICES within 24 hours
Attach a copy of your Drivers Licence and a copy of the photograph page of your ID book to
this card.

In terms of claims operations we have recently segmented claims functionalities in respect of a
separate focus on recovery and liability claims.
A dedicated recovery/liability claims handler in the PE and Durban branches will enhance the
financial bottom line.

PE, Cape Town recovery/liability claims:
Annamarie Wentzel (PE office)

Durban and surrounds recovery /liability claims:
Liza- Jayne Goddard (Durban office)

				
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