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Claimant's Car Plate Number *

Claimant's NRIC/UEN *

Claimant's Name

Claimant's Address

Make & Model

Date of Accident

3rd Party's Car Plate Number

3P Insurer/Details

3P additional details

Key in the 3P Insurer/Details name in the text box above

Name of Surveyor

Surveyor's Email

Case Facts

Is Own Damage? *

Yes

No

Has LTA Search? *

Yes

No

Has Parts Estimate? *

Yes

No

Has Marked Estimate? *

Yes

No

Has Evidence? *

Yes

No

Has Rental Invoice? *

Yes

No

Parts Estimate Documents

Pre Repair Survey Email

GIA/Draft *

Letter of Authorisation and Warrant To Act signed by Claimant (signature to match with accident report) *

3P GIA Report

LTA Search

NRIC and Drivers' License of Driver and Vehicle Owner

Photos and Video of Accident

Please zip all evidence into 1 file

Police Report

Rental Invoice

Towing Receipt

After Repair Photos

Marked Estimate

Adjusted Marked Estimate

Supplementary Estimate

Satisfaction Voucher