Tel :
011 783 5013
Fax :
011 883 8477
Email :
info@royaladmin.co.za
Claims Handler
Date
Authorised by
Telephone Number
Email
Insured Details
Insurer
Claim Number
Accident Date
Insured Name
ID No.
Driver
Contact Number
Vehicle Type
Reg No.
Type of Incident
Accident
Theft
Write-off
Rental Details
Car Group
T - 1.3 Manual
B - 1.4/1.6 Manual
C - Manual Sedan
D - 1.6 A/T
Y - LDV 1 Ton - Open
H - BMW 320i
O - Mercedes C181
E - 8 Seater
Date Hired From
Total Days Required
Max. Days Allowed
Panelbeater Name
Panelbeater Contact Number
Remarks
All Rights Reserved. Royal Administrators
1st Floor Tropicana House, 1 Palmboom Place Athol Ext 12 Sandton P.O. Box 787, Strathavon, 2031