What kind of incident was it?

Were you at fault?

Yes No

When did this incident happen?

Did it affect your No Claims Bonus, or if your bonus is protected, did you lose a 'life' on the protection?

Yes No

Was a claim made against the proposer's policy?

Yes No

Is this claim pending?

Yes No

Do you know the total claims costs?

Yes No

How much did the claim cost?