Loss Notification Form

Please note that if you require urgent assistance because your vehicle is not driveable and the damage is covered under your policy you should report your claim by telephone to 0330 024 8000. Do not complete this form, as you will be asked the same questions when you telephone and the information will be recorded for you.

If you are making a claim for glass/windscreen only, please contact the above number and you will be transferred to an approved supplier, you do not need to complete the below form.
Information about you
Are you (please select):*

A. The policyholderB. Driver named on the policyC. The insured's brokerD. A relative or friend of the insured
I have express authority to complete this form on behalf of the policyholder and all information and answers that I provide will represent the answers and wishes of the policy holder. I confirm that the information that I provide in this form will be a complete and accurate record of the information provided to me by the policy holder.*

I confirm the above is true.
If our mutual customer does not wish to claim under the policy then you may complete the shorter broker notification form -

https://sabre.co.uk/broker/broker-notification-form/
Policyholders First Name*
Policyholders Surname*
Policyholders Telephone number*
Policyholders Email address*
Please note e-mail is our preferred method of communication
Policyholders Address*

Street Address

Street Address Line 2

CityCounty

Post Code
What is the policy number? (if known)
As you are not the policyholder please provide:
Your First Name
Your Surname
Your Telephone Number
Your Email Address

Further Policyholder Details
Who was driving/last in charge of the vehicle?*
Policyholder Date of Birth

DayMonthYear
Date
Policyholder occupation
Policyholder Part-time occupation (if applicable)
Licence type*

FullProvisionalEUInternational
Date driving test passed

DayMonthYear
Date
Please confirm when Policyholder last left the country
Accompanying Drivers name
As someone else was driving the car please complete the information below
Drivers name
Drivers Date of Birth

DayMonthYear
Date
Drivers occupation
Drivers Part-time occupation (if applicable)
Drivers licence type

FullProvisionalEUInternational
Date driving test passed

DayMonthYear
Date
Please confirm when driver last left the country
Accompanying Drivers name
If the driver has Driving Other Cars cover on their own policy then please enter the details below.
Drivers Insurer (if known)
Drivers policy number (if known)

Information about your Vehicle
Insured Vehicle's registration number*
Registration of vehicle you were driving if different from above
Make of your vehicle*
Model of your vehicle*

Incident Details
Nature of the Incident*

AccidentTheftFireVandalismFloodStorm damageCollision with pedestrian or cyclistOther
Date & time of Incident

DayMonthYear
DateHourMinutesAM/PM Option
Incident Location*
E.g. Junction 10 M25, Cobham, Surrey

Incident Details - Continued
Please give a concise description of what happened*
Include the weather and road conditions, and the speed at which the vehicles were travelling
Please sketch the accident circumstances
You may wish to use Google Maps or Google Street View to assist you.
Speed of your vehicle (if collision)
Purpose of Journey (eg. Travelling to shop)*
Do you accept responsibility for the accident?*

YesNo
Are you happy for us to settle any claims made against you?*

YesNo
Please detail why you believe we shouldn't settle any claims made against you?

Where was the vehicle damaged?
Please mark where the impact was to your vehicle -
Please describe extent and areas of damage to your vehicle below -
Is the vehicle driveable?*

YesNo

Emergency services
Were any emergency services involved? Select all that apply
Emergency services

PoliceAmbulanceFire service
If the police were involved please complete the incident details below
Station details
Reporting officer details
Police reference

Number of people involved
Number of people in your vehicle (including the driver)*
Details of injuries sustained by anybody in your vehicle
Information about any other person, vehicle (third party) or property involved in the incident
Do you have any details about the third party?

YesNo
Please provide details of any other parties involved:
Third Party Name
Third Party Address

Street Address

Street Address Line 2

CityCounty

Post Code
Third Party Telephone
Third Party e-mail address
Vehicle registration number
Vehicle make
Vehicle model
Colour of vehicle
Number of vehicle occupants including the driver
Details of any injuries sustained by any occupant of this vehicle
Please mark where the impact was to Third Party vehicle -
Estimated speed of Third Party
Add another vehicle?

Check box to add
Third Party 2 Name
Third Party 2 Address

Street Address

Street Address Line 2

CityCounty

Post Code
Third Party 2 Telephone
Third Party 2 e-mail address
Vehicle registration number
Vehicle make
Vehicle model
Colour of vehicle
Number of vehicle occupants including the driver
Details of any injuries sustained by any occupant of this vehicle
Please mark where the impact was to Third Party vehicle -
Estimated speed of Third Party
Other people involved
Were any other people involved in the incident (e.g. pedestrian, cyclist, etc).

YesNo
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone
E-mail address
Role (Pedestrian/Cyclist/Pillion)
Nature of injury (please provide as much detail as possible)
How did this person leave the scene of the accident?
If other please specify
If damage was caused to any other property please give details
Add another person

Check box to add
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone Number
E-Mail Address
Role (Pedestrian/Cyclist/Pillion)
Nature of injury (please provide as much detail as possible)
How did this person leave the scene of the accident?
If other please specify
If damage was caused to any other property please give details

Additional information
Is there any more information you would like to add about your incident?
Images and Documents
Please upload any images

Browse Files

Cancelof
Any photographs of the scene of the accident, the vehicles or vehicle damage may be emailed to us at claims@sabre.co.uk

This email address may also be used for documents such as Google Maps, written admissions, Third party social media, Third Party correspondence, etc.

We would recommend that you limit the size of any email attachments to 10 MB. We are happy for you to split the documents into more than one email. Any larger files, such as video, that you wish to send should be copied to a disc and posted to Sabre Insurance at 150 South Street, Dorking RH4 2YY.

Always ensure that your policy, claim number or vehicle registration are included in the subject line of any email or are clearly displayed on any written communication. We would recommend that you also include either your vehicle registration number or post code to make certain that we can identify your documents.
What will happen next?
An e-mail will be sent shortly confirming the information you have provided and a further e-mail will be sent within two working days with details of what will happen next and contact information for your dedicated claim handler.

Please note that we can only discuss this claim with the Policy Holder or a driver named on the policy. Authority can be given over the telephone to allow us to discuss with other individuals.

Important

If any false statement, fraudulent or exaggerated claim is made under this policy or any fraudulent means are used to obtain any benefit under this Policy then no part of any claim will be paid and all cover under the Policy will be forfeited.
Signature

Clear
I confirm that the information provided in this form is true.*

Check to confirm
Should be Empty:

Information about you

Further Policyholder Details

Information about your Vehicle

Accident/Claim history

Accident 1

Accident 2

Accident 3

Convictions / fixed penalty offences

Conviction/fixed penalty 2

Conviction/fixed penalty 3

Conviction/fixed penalty 2

Conviction/fixed penalty 3

Incident Details

Incident Details - Continued

Where was the vehicle damaged?

Repairs

Witnesses

Witness details

Witness 2

Witness 3

Emergency services

Number of people involved

Information about any other person, vehicle (third party) or property involved in the incident

Other people involved

Additional information

Images and Documents

What will happen next?