Initial Claims Advice Form - Windscreen Claims

If immediate advice is required, please phone us on (09)579 5794.

Alternatively you can notify us of a claim by completing the brief form below and we will contact you to organise repairs.

We have arrangements with preferred suppliers and provide a lifetime guarantee for all workmanship.

Fields with an asterix (*) are compulsory

Name of Insured*:
Contact Name*:
Contact Phone Number*:
Registration No.*:
Vehicle*:
(make and model)
Date of Loss*:
Policy Number:
(if known)

Additional or relevant information:

 



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