Submit a Claim

Referral Portal

Provide details of the vehicle damage, incident description, and upload supporting photos to initiate a claim review.

Vehicle Number Plate *

We will verify if this plate has an active policy schedule.

Claimant Full Name *

Claimant Phone Number *

Claimant Email Address (Optional)

Date of Incident *

Estimated Loss Value (UGX) *

Description of Incident *

Please upload clear photos showing the damaged areas of the car.

Damage Photo 1 * Tap to snap / upload file

Damage Photo 2 (Optional) Tap to snap / upload file

Damage Photo 3 (Optional) Tap to snap / upload file

Upload any supporting PDF or image relevant to your claim.

Supporting Document (Optional) Tap to snap / upload file