Total Loss Claim — Form of Authority

1 · Your details
2 · Read the authority
3 · Sign & submit

Your details

Check the details below and correct anything that is wrong. We use these on the authority document sent to your insurer.

The authority you are giving

Please read this carefully before signing.

I appoint and authorise to act as my representative in relation to my vehicle total-loss / write-off undervaluation claim.

This authority includes permission to request, receive, review and rely on insurer claim notes, settlement calculations, engineer reports, valuation-guide evidence, vehicle condition and mileage records, market valuation evidence, correspondence, complaint responses and any other material reasonably required to assess and progress the claim.

I authorise the insurer, broker, intermediary, engineer, valuation provider, repairer, salvage agent, the Financial Ombudsman Service and any relevant third party to communicate with and to release information to them about this matter.

This authority remains valid until withdrawn by me in writing.

Sign here

Draw your signature in the box using your finger, stylus or mouse.

Your signature is applied to the authority document with the date, time and a signing certificate.