Details about what happened?

What type of incident was it? *

Please provide details of the incident *

When did it happen? * When did it happen? *

Help incident date/time help

What time did it happen? *

Please use the 24hr time format

Where did it happen? *

Please enter street name, postcode town or city.

Does the insured driver believe they were at fault? *

Help Yes No Unsure

Was anyone injured as a result of the accident? *

Yes No

Provide their name, address and details of their injury *

Briefly describe what happened (maximum of 1330 characters). *

Include relevant details, for example, the weather condition, speed, road layout, if the emergency services were called or any evidence available.

1330 characters left

Provide all witness name and contact information

About the policy and the driver

Complete the information below to the best of your knowledge to help us deal with the claim

Select the relevant insurance policy *

Policy contact details

Policyholder / Company name *

Policyholder / Company telephone
number *

Policyholder / Company email address *

Policy number *

Help

Driver contact details

Driver's first name *

Driver's surname *

Driver's date of birth

Driver's telephone number *

Driver's email address *

When did the driver pass their test?

Vehicle registration * *

Main contact

Main contact for the claim *

Name *

Telephone number *

Email address *

Relationship to Policyholder *

About the third party

Do you have any details about the third party involved? *

Yes No

What is their first name?

What is their surname?

What is their registration number?

What is their daytime telephone number?

What is their house name/number and street name?

What is their address line 2?

What is their address line 3?

What is their town or city?

What is their postcode?

Add another third party

If you have any other details about any third party involved please enter them here (maximum of 1000 characters)

1000 characters left

Third Party details

Edit

About the additional third party

What is their first name?

What is their surname?

What is their registration number?

What is their daytime telephone number?

What is their house name/number and street name?

What is their address line 2?

What is their address line 3?

What is their town or city?

What is their postcode?

Additional support

Are there any additional support needs you'd like us to be aware of and note on our system? *

Yes No Unsure

Telling us about additional support needs helps Aviva and our suppliers to provide the right level of communication or support when managing the claim. Information should only be provided with the individual's consent. If circumstances change please contact us so we can update our claims records and continue to provide the appropriate support.

Examples might include:

A recent bereavement
The need for documentation in an alternative format such as braille
A temporary or permanent health condition or a significant life event

Provide details of the additional support needs *

Welcome to Aviva Motor Claims

What happened?

Details about what happened?

About the policy and the driver

Policy contact details

Driver contact details

Your vehicle

Main contact

About the third party

Their vehicle

About the additional third party

Their vehicle

About the damage to the vehicle

Front

Roof and rear

Passenger (left) side

Driver's (right) side

Other

Type of damage

Additional damage information

Additional support