Accident Form

Accident Form

IMPORTANT: IF YOU HAD AN ACCIDENT WITH ANOTHER CAR WE NEED THE LICENCE PHOTO OF THE OTHER DRIVER, THEIR NUMBER PLATE AND PHONE NUMBER. WITHOUT THIS WE CANNOT MAKE A CLAIM ON YOUR BEHALF AND YOU WILL NOT BE ELIGIBLE FOR INSURANCE COVERAGE.
Date and Time of Accident?

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
What was the Location of the Accident?
Please add Street Name, Closest Street Number or Intersection and Suburb. If it's easier, take a phone screenshot of the location on your maps and upload it later in this form.
Was there another car or person involved in the accident? (DID ANOTHER CAR/TRUCK/VAN/PERSON HIT YOU OR DID YOU HIT THEM?) YOU MUST ANSWER THIS CORRECTLY FOR INSURANCE.
If the other driver was at fault, we can help you with the paperwork for your claim. If their insurer pays the full damages, we refund your bond.
What is the Registration Number of the other vehicle?
Please enter the registration number of the other vehicle
Upload a Photo of their License Back and Front

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What is their Phone Number?
Third Party Phone Number (if known)
What is their Vehicle Make, Model and Colour?
Example: Toyota Camry White
Other driver's full name
Other driver's address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Other driver's insurer
Other driver's insurance claim number (if they have one)
Does the other driver own the car?
If not, what is the owner's name?
Upload a photo of their number plate

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Did the other driver admit fault?
What Happened?
Please outline what happened in detail.
Upload any dashcam or CCTV footage or photos

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Were the police at the accident?
Were there any witnesses who saw the accident?
What is their name and phone number?
Weather Conditions at the time of the accident (select all that apply)
What was the speed limit on the street the accident occured?
Rider declaration
Rider declaration
Your signature
Your Nibble booking number (NB)
Is the bike rideable?
Do you require towing?
What is the Police Report Number?
Optional. If you do not have it yet, you can add it later by texting 0435 064 450 or chatting at nibblebikes.com.au.
Were you injured in the accident? You may be eligible for compensation.