Make a Claim > Motor Claim Notification

Motor Claim Notification

This form allows you to notify WFI of a loss for which you wish to lodge a claim. We will contact you for further particulars and to assist you.

You must complete fields marked with an *
You must complete at least one of the fields marked with an **

About You

Date	*
Name Of Insured
Policy Number
Vehicle Registration	*
Date Of Loss	*
Reported to Police?
Police Report Number
Where is the vehicle located now?
Was the vehicle towed?
Who was driving the vehicle?
Driver's Age
Was there a third party involved?
What is the name of the third party?
Description Of Loss

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