Accident Management & Replacement Hire Vehicle Specialists

A problem shared is a problem solved with UA

Our promise is to keep you moving

UA for life's Unexpected Accidents

Claim Form

Please use the form below to send us your claim information. (Must be filled in by the Vehicle Owner)
* Minimum Required Information

*Client name:
*Address:
*Postcode:
*Tel:
Tel Work:
*Mobile:
*Accident Description:
*Accident Date (DD/MM/YY):
*Time of Accident:
*Accident Location
Witness Name:
Witness Address:
*T/P Name:
T/P Address:
Postcode:
Tel:
*Vehicle Make & Model
*Vehicle Registration:
*Insurer:
*Policy No:
Reference:
Insurers contacted on the (date):
Spoke With:
Referer:
Driver:
Licence No:
Type:
Full:
Prov:
Held for:
Convictions (Yes or No):
If Yes, Please note them here:
Disqualified (Please write Yes or No):
If Yes, How long for:
DOB:
Occupation:
Contact:
VAT Reg (Please write Yes or No):
Vehicle Make:
Vehicle Model:
Registration:
Colour:
Engine Size:
Insurer:
Policy No:
Damage:
Roadworthy:
Unroadworthy:
Repairer:
Tel:
Engineer Instructed (Yes or No):
Estimate Obtained (Yes or No):
Labour Figure:
Additional information:

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Free Impartial Advice

If you have been involved in a car accident that was not your fault, take advantage of our free, no obligation legal advice. We will give you a free claim assessment and answer any questions you may have about making a car accident claim.

Arrange An Immediate Replace Vehicle

If the car accident has resulted in your car being written-off or undriveable we can help you by arranging a replacement vehicle for you in no time at all. Contact us today for more information.

Had An Accident?

In the event of a road traffic accident call our accident helpline on 0843 077 5001 or alternatively fill in our contact form

"Our personal service provides the very best client care, which in turn delivers the highest levels of case retention for our referrers".

Claim Form

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Free Impartial Advice

Arrange An Immediate Replace Vehicle

Had An Accident?