Motor Vehicle Accident Report
To enquire about how to report an accident or make a claim under your Motor Vehicle policy you may contact us directly. If you wish to make a claim under your policy, we will forward a Claim Notification Form within 2 working days.

Please read your policy document carefully to ensure you fully understand your policy terms and conditions.

Policy Holder Information
Name

Address
Email
Telephone
Policy Number
   
Details Of Incident

Date Of Incident
Registration Number
Make of car
Name of driver
Estimated damage to vehicle
Where can the vehicle be assessed
Is the car drivable
Telephone number of garage/repairer
Please describe what happened
   
If the incident involves a third party, please complete the following
Do you consider yourself to be at fault
Name of third party
Telephone number of third party
Address of third party
Registration of their vehicle
Make of their vehicle
Policy number of their insurance (if known)
Name of their insurance company
   



 
     
Tom Fogarty Insurance Brokers -16 Bank Place, Tipperary Town Tel: 062-51116 Fax: 062-51816 Email:info@tfi.ie