Insurers pass information to the Motor Insurance Anti-Fraud and Theft Register run by the Association of British Insurers (ABI). The aim is to help us to check information provided and also to prevent fraudulent claims. Under the conditions of your policy, you must tell us about any incident (such as an accident or theft) which may give rise to a claim. We will pass information relating to this incident to the register.

Submission of a bogus or exaggerated claim, either in whole or in part, or of any false documentation or statement in support of a claim, may invalidate the whole claim and lead to your policy being declared void.

I declare that the above statements are true and correct to the best of my knowledge and belief

I have not withheld any information within my knowledge connected with this form

I agree to provide the Insurer with any further information or documentation as may be reasonably required

I understand that the Insurer does not admit liability by the issue of this form

I confirm I am authorised to provide information contained in this form

I confirm that I have read and understand the above declaration. *