Report a traffic accident

Information about the accident

Date of the accident*

Please specify the date that the accident took place

Country of accident*

Please select the country where the accident took place.

Scene of the accident (city, street/road)*

Description of the accident*

Untitled*

Accident statement completed
Accident registered with the police

Information about liable party

Make and model of liable vehicle*

Registration plate number of liable vehicle*

Country of registration of liable vehicle*

Insurance policy (contract) No. of liable vehicle*

Name of insurance company of liable vehicle*

Name and surname of liable driver

Information about the damages

Damaged vehicle

Damaged vehicle

Make and model of the damaged vehicle*

Registration plate number of the damaged vehicle*

Vehicle identification number (VIN) of the damaged vehicle*

Country of registration of the damaged vehicle*

IMPORTANT: Prior to beginning repair work, an estimate from the company doing the repairs must be provided for approval in case of accidents in the country of damaged vehicle's registration.

Someone was injured/killed

Someone was injured/killed

Name and surname	Country of registered residence

Other damages

Other damages

Untitled

Information about the insurance compensation

Type of payment*

I intend to repair the damaged property
I would like to receive the insurance payment in cash

Name and surname/company name of the owner of the damaged property*

Bank account number of the owner of the damaged property*

Claim's handling documents

To expedite the claim's handling process, we kindly ask you to immediately attach all available (relevant) documents. Tick the documents that will be attached

Accident statement/Police report

Vehicle registration certificate

Driving licence

Photos of the damages done to the vehicle

Photos of the scene of the accident

Power of attorney (where damage is being reported by an authorised person)

Other documents

Documents

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.

Information about the reporting (contact) person

Name*

Surname*

Contact telephone number (+370 6...)*

E-mail address*

Consent*

I hereby confirm that the information contained in this report is accurate and correct and grant iClaim the right to obtain information from public and private authorities who have data about this incident.

Sutikimas*

I agree that iClaim, while handling the above-mentioned claim, will process all data (including personal data) provided for the administration of this file and transfer it to the third parties (e.g. lawyers, experts, appraisers, doctors, etc.) providing iClaim services related to the administration of this claim.