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If you prefer not to use this On-Line claim form, just phone the Claims Line to report the RTA (0845 108 5377), or Ask for call back.

(Alternatively you can download and print off a claim form and then fax or post the completed form to us <CLICK HERE for PDF Claim Form>. You will need Adobe Acrobat installed on your computer to download this form. The download may take a few minutes to complete, when you are through using the form, just close the window to return to this web site!)

THE ON-LINE CLAIM FORM:

In the first part of the On-Line form, we shall ask you for some basic details. Just leave blank any information that you do not have.

When you have finished, click SUBMIT button and complete the second part of this page.

<.<.STEP 1, CLICK HERE>>


STEP 2.  In the box below please give a description of the accident, and please say who you think was at fault and why. Please also confirm the date and time of the accident.



Last name:
First name:
E-Mail:
Phone:
Comment:
 
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