New Insurance Claim

Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Please enter the make, model & registration of your vehicle *
For example: VW Polo, GF20 ABC
Please provide us with the 5 digit job reference we have sent you *
For Example: 26666

What Do We Require

Please watch the short slide show below, which explains all the images that we require in order to carry out a comprehensive an accurate estimate. The importance of good images, means that we are able to be more thorough with the estimates and reduce the impact of "hidden" damages discovered when the vehicle arrives on site.

Upload Your Images

Minimum Of 6 Images Required
Full Front View Image *

Cancel of
Image of Chassis Number *

This can be found in the lower passengers corner of the windscreen, inside one of your door shuts and on some vehicles (Fiats & Abarths mainly) it can be found in the boot by the spare wheel. An example of a chassis number is: MDHFBUK13U0063659 or WAUZZZ8XXHB050453
Cancel of
Image of the mileage *

Cancel of
Area of Damage *

Cancel of
Close Up Image Of Damage *

Cancel of
Supporting Image *

Cancel of
Supporting Image

Cancel of
Supporting Image

Cancel of
Supporting Image

Cancel of
Supporting Image

Cancel of
Please add any other information here that may help us whilst compiling the estimate. This could be dash warning lights, steering alignment issues, abnormal noises. Anything that is out of the ordinary, let us know especially if it is accident related.

Is there anything else we could estimate for you?

Whilst your vehicle is in for repairs, now is the perfect time to get any little jobs that you have been meaning to get done over the years. Whether thats additional bodywork, new tyres, a service, MOT. Whatever it may be, let us know below and add some additional images above. We can the cost these repairs accordingly and if you are happy, we can then look to complete the repairs alongside your insurance work.
Please enter your additional requirements here

I First Name Last Name understand that any information provided above will have an impact on the estimate carried out to my vehicle. All details related to the insurance claim only is accurate and my insurance company have had the same information provided to them. I also understand that any additional estimates requested will NOT be relayed to the insurance company by PK Motors ARC Ltd unless otherwise instructed to do so.
Signature

Clear
Date

Month Day Year
Date
Should be Empty:

What Do We Require