Details of who is involved 

For convenience you can enter your details. 

Please make sure all the details are correct.

Your Details :


Name :

Contact number :

E-mail :

Vehicle details :

Rego :

Make :

Model :


Other Party Details :



Address :

Contact number :

Vehicle details :

Rego :

Make :

Insurance Company :

Claim Number :

Date of incident :

You can cut & paste 

into the e-mail 



These details are important to any claim against someone.



We do need to obtain a claim number.

Example E-Mail.


Hello Wayne,


My name is Samantha, I drive a blue Honda Civic,

Rego XXY123.


I was run into the rear whilst stopped at red light last Tuesday night about 7.30 pm.

The other party have told me they have insurance.


Their details are,

Mr Darryl Lee, of 5 Lee Street, Leston. The vehicle was blue, but not sure what it was.

The Rego is  ( DRLEE1).


He has told me he is insured with xxxxxxx.

I have contacted him and his claim number is 123456.

His phone number is 043___________567

He was a very nice man and I felt sorry for him, he was so apologetic.


My number is 040______123.







Warning : Your email

  • will not be accepted.

  • Leave out the au

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