MOTOR THEFT CLAIM LETTER AND INDEMNITY

A claim under a motor insurance policy for a stolen vehicle, with the owner's indemnity to the insurer.

TO:
The Claims Manager
__________
__________

FROM:
__________
__________
Phone: __________

SUBJECT: Theft claim under policy no. __________ for vehicle __________

Sir / Madam,

PART A. THE CLAIM

1. THE POLICY AND THE VEHICLE

1.1 I am the insured owner of __________, registration no. __________, engine and chassis nos. __________, insured with you under motor policy no. __________.

2. THE THEFT

3. WHAT I ASK YOU TO DO

3.1 Please register this claim, give me the claim number in writing, and tell me in one list every paper you still need, with the name and number of the officer handling the claim.

3.2 Please settle the claim for the insured value of the vehicle, less only what the policy allows, and give me each deduction in writing with the clause of the policy you rely on.

PART B. INDEMNITY AND UNDERTAKING

4. WHAT I PROMISE

4.1 In return for your settling this claim, I, __________, promise and agree as follows.

4.2 I will hand over to you the original registration certificate, the original keys and such other papers and things as you reasonably ask for, and will sign any letter of transfer or subrogation needed to pass the vehicle to you once the claim is settled.

4.3 If the vehicle is found, before or after the claim is paid, I will tell you at once. If it is found after payment, I will give it to you, or, if you choose, take it back and repay the amount you paid me for it.

4.4 I have not sold, pledged or parted with the vehicle, and no other insurer has been or will be asked to pay for the same loss.

4.5 I will make good to you any loss, claim or expense that you suffer because a statement in this letter is untrue, or because another person has a right in the vehicle that I did not tell you of, including a financier.

4.6 This promise is given to __________ and binds my heirs and legal representatives.

5. WHAT I CONFIRM

5.1 What I have written is true to the best of my knowledge, and I have kept back no fact that you would reasonably want to know.

6. PAPERS ENCLOSED

Yours faithfully,

Witnesses to Part B (two):

1. 1. Name: _________________ Address: _________________ Signature: _________________

1. 2. Name: _________________ Address: _________________ Signature: _________________