Report your cycling accident
Report your cycling accident
Call us or use our online form below to get help
Call our cycling accident helpline:
☎ 0800 179 9002
This line is dedicated to accident assistance ONLY and is not a general enquiries line
If you have an enquiry, please click here
You can report an accident to us instantly with the form below. Don't worry if there are some boxes you leave blank; just tell us what you can.
About you
First name:
Surname:
Email:
Mobile tel:
Home tel:
Date of birth:
Your address
Line1:
Line 2:
Town:
County:
Post code:
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About your cycle:
Make & model:
Age:
Value:
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Date, time & location of the accident:
Date & time:
Location:
Who is at fault for the accident?
Is there a third party involved?
Yes/No...
Yes
No
Who do you think is at fault?
Please select...
100% my own fault
100% Third Party's fault
Mixed fault/not sure
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About the Third Party (if applicable):
Is the Third Party identified?
Yes/No...
Yes
No
If yes, Third Party's name:
Third Party's email:
Third Party's contact tel:
Third Party's address & postcode:
Third Party's vehicle make:
Third Party's vehicle model:
Third Party's vehicle reg:
Is the Third Party insured?
Yes/No...
Yes
No
If yes, Third Party's insurer:
Has Third Party admitted liability?
Yes/No...
Yes
No
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About the damage to your cycle:
Is your cycle damaged?
Yes/No...
Yes
No
If yes, please describe the damage to your cycle:
About any injuries to you and/or your passenger(s):
Are there any injuries?
Yes/No...
Yes
No
If yes, please describe the injuries and who has suffered them:
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About any witnesses to the accident:
Were there any witnesses?
Yes/No...
Yes
No
If yes, please enter the name(s) and contact details of any witnesses:
Police and ambulance:
Were the police involved?
Yes/No...
Yes
No
Was an ambulance called?
Yes/No...
Yes
No
If yes to either question, please add any details below:
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Your description of what happened:
Security word:
Please enter the word you can see above: