Motor Insurance Claim Form

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Motor Insurance Claim Formfkm-sidian2019-12-09T22:32:19+03:00

Motor Insurance Claim Form

Bancassurance - Motor Claim

Name*
First Middle Last
Phone*
Email*
Date of the Incident
Date Format: MM slash DD slash YYYY
Vehicle Registration Number*
Type of Claim*
- Windscreen/ Radio Claim
- Accident Claim
- Theft Claim