To process your Not At Fault Claim, we require the Offending Vehicle's Registration Number as a minimum.
If you have any other information of the At Fault Party, please provide it in the following fields to help support your claim.
Required fields are marked with *
1. Before you sign this form contact us if you have any questions;
2. Complete the details on this form fully and truthfully. Provide as much information as possible;
3. Sign and return the form to us. Our address is on the first page;
4. Be prepared to provide us with a copy of the vehicle registration certificate and any other information
about the collision
5. If you are comprehensively insured, lodge a claim form with your insurer marked “Report Only”. This will
protect your rights and will not affect your no claim bonus if a claim is not made;
6. Refer any communications from the offending party or their insurers to us. Do not communicate directly
with these people.
1. Ensure that your vehicle is assessed by qualified assessors. There is no need for you to obtain any
2. Make a claim on the offending party or their insurers. Upon recovery of funds, we will pay the repairer
directly for the repair cost;
3. All costs and charges will be paid by the offending party or their insurance company. The repairer will
also contribute to these costs and charges.
I / We instruct National Motor Claims to act on my / our behalf to recover the losses arising from the collision as
set out on this form.
I / We authorise National Motor Claims to:
I / We have been made aware of section 60 of the GICOP.
* Ts & Cs apply.
Thank you for submitting your Not At Fault Claim with National Motor Claims.
One of our Claims Specialists will be in contact with you shortly.
A copy of your Not At Fault Claim Form has been sent to you via e-mail.