Motor
02/08/2019
Jason Smith
WWW 9999
abc@example.com
0123456789
Own Damage Claim
Myself
Non Motor
F0000000
Technical Report confirming the actual cause and extent of damage
Replacement or Repair Bill/ Invoice/ Quotation detailing the description, unit price and amount
A copy of Police Report
Purchase Invoice of the damage/stolen item(s)
Photograph(s) depicting the damaged items
Claim Form
E-Payment Form
Others