Report Motor Accident - Nagico Insurances : Nagico Insurances

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Report Motor Accident

NAGICO insured's name (when insured is a company)
Policy number*
Policy Holders first name*
Policyholder's last name*
Your phone number*
Your email address*
Select your Intermediary-St Maarten*
Date of Accident*
DD slash MM slash YYYY
Approx. time of the accident*

: Hours

Minutes

AM/PM
Were there any persons injured in this accident?*
- Yes
- No
- Not Applicable
Was there police at the scene of the accident?
- Yes
- No
- Not Applicable
Please describe your loss (e.g. how, where, when, what happened, with whom)*
Upload Relevant Documents
Drivers Licenses*
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, xls, xlsx, mp4, mp3, rtf, csv, txt, Max. file size: 128 MB, Max. files: 10.
Other Party's Insurance Documents*
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, xls, xlsx, mp4, mp3, rtf, csv, txt, Max. file size: 128 MB, Max. files: 10.
Accident scene video describing what happened and where (include traffic signs and road markings)*
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, xls, xlsx, mp4, mp3, rtf, csv, txt, Max. file size: 128 MB, Max. files: 10.
Vehicle damage photos / video (showing registration number of each vehicle)
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, xls, xlsx, mp4, mp3, rtf, csv, txt, Max. file size: 128 MB, Max. files: 10.
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