All Countries
Insurance
Motor Insurance Claim Form

Motor Insurance Claim Form Template for Belgium

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Motor Insurance Claim Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Motor Insurance Claim Form

"I need a Motor Insurance Claim Form for our Belgian fleet management company that handles international transport across the EU, with specific sections for cross-border incidents and multiple language support for drivers from different countries."

Celebrated by
Collaborations with
Investors
Document background
The Motor Insurance Claim Form is a crucial document used in the Belgian insurance market when policyholders need to report a vehicle-related incident and make an insurance claim. It is designed to comply with the Law of 4 April 2014 on Insurance and relevant EU directives, particularly the Motor Insurance Directive 2009/103/EC. The form collects essential information about the accident, including vehicle details, circumstance descriptions, witness statements, and damage assessment, while ensuring compliance with GDPR and Belgian data protection requirements. This standardized document facilitates efficient claims processing and helps ensure all necessary information is gathered at the initial reporting stage, supporting both the insurer's assessment process and the policyholder's claim.
Suggested Sections

1. Policyholder Information: Essential details about the insurance policyholder including policy number, name, address, contact information, and policy validity dates

2. Vehicle Details: Comprehensive information about the insured vehicle including make, model, registration number, and current condition

3. Accident Information: Details about when, where, and how the accident occurred, including date, time, location, and weather conditions

4. Damage Description: Detailed description of the damage sustained by the vehicle, including visual documentation references

5. Third Party Information: Details of other parties involved in the accident, including their insurance information

6. Witness Information: Contact details of any witnesses to the accident

7. Police Report: Information about police involvement, including report numbers and responding officer details

8. Declaration: Formal statement confirming the truth of the information provided, including data protection notices and signature section

Optional Sections

1. Personal Injury Section: To be included when the accident resulted in injuries to any party, including details of injuries and medical treatment

2. Property Damage Section: For cases involving damage to property other than vehicles

3. Multiple Vehicle Involvement: Additional section for accidents involving more than two vehicles

4. Foreign Jurisdiction Details: Required when accident occurred outside Belgium but within EU coverage area

5. Theft Report: Specific section for claims related to vehicle theft rather than accidents

Suggested Schedules

1. Schedule A - Photograph Log: List and description of all photographs submitted as evidence of damage

2. Schedule B - Repair Estimate: Detailed estimate from approved repair shop or mechanic

3. Schedule C - Additional Documentation: List of supporting documents including police reports, witness statements, and medical reports

4. Appendix 1 - Sketch of Accident: Template for drawing accident scene diagram

5. Appendix 2 - Vehicle Damage Marking Sheet: Diagram template for marking areas of vehicle damage

6. Appendix 3 - Privacy Notice: Detailed information about how personal data will be processed in accordance with GDPR

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Clauses
Personal Data Protection
Declaration of Truth
Consent to Process
Information Disclosure
Documentation Requirements
Liability Assessment
Damage Description
Accident Circumstances
Third Party Details
Vehicle Identification
Policy Verification
Claims Processing
Photo Evidence Requirements
Witness Statements
Police Report Reference
Medical Information Release
Property Damage Assessment
Financial Loss Declaration
Insurance Coverage Confirmation
Fraud Warning
Authority to Investigate
Rights Reservation
Jurisdiction and Applicable Law
Data Sharing Authorization
Document Submission Requirements
Relevant Industries

Insurance

Automotive

Legal Services

Healthcare

Vehicle Repair and Maintenance

Transportation

Fleet Management

Risk Management

Relevant Teams

Claims Processing

Legal

Compliance

Customer Service

Risk Assessment

Document Management

Policy Administration

Fraud Investigation

Client Relations

Relevant Roles

Insurance Claims Handler

Risk Assessor

Insurance Underwriter

Claims Manager

Legal Counsel

Compliance Officer

Insurance Broker

Fleet Manager

Customer Service Representative

Insurance Policy Administrator

Claims Investigator

Document Management Specialist

Industries
Law of 4 April 2014 on Insurance: The primary Belgian insurance law that governs all insurance contracts, including motor insurance. It sets out the basic rights and obligations of insurers and insured parties, including claim procedures and time limits.
Royal Decree of 16 April 2018: Specifies the minimum terms and conditions for compulsory motor vehicle liability insurance in Belgium, including claim handling procedures and documentation requirements.
EU Motor Insurance Directive 2009/103/EC: European directive implemented in Belgian law concerning motor vehicle insurance and the obligation to insure against civil liability, including cross-border claims handling.
Belgian Civil Code (Articles 1382-1386): Fundamental provisions regarding civil liability and damages that apply to motor vehicle accidents and insurance claims.
GDPR (General Data Protection Regulation): EU regulation implemented in Belgium governing the collection and processing of personal data in insurance claims, including requirements for consent and data security.
Belgian Law of 30 July 2018 on Data Protection: National implementation of GDPR principles, specific to Belgian context, affecting how personal information must be handled in insurance claim forms.
Book VI of the Belgian Code of Economic Law: Contains provisions on consumer protection and unfair terms that apply to insurance contracts and claim procedures.
Royal Decree of 12 October 1990: Regulations concerning motor vehicle insurance claim settlements and compensation procedures in Belgium.
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Surety Bond Certificate Of (Insurance)

A Belgian law-governed insurance certificate providing financial guarantee from an insurer to protect against a party's non-performance or default of obligations.

find out more

Motor Insurance Claim Form

A Belgian-compliant motor insurance claim form for reporting vehicle incidents and initiating insurance claims process under Belgian law.

find out more

Insurance Proposal

A Belgian-law governed insurance proposal document that outlines proposed insurance coverage terms and conditions, compliant with the Insurance Act of 2014.

find out more

Insurance Claim Form

A Belgian-law compliant Insurance Claim Form for filing insurance claims, structured according to Belgian insurance regulations and GDPR requirements.

find out more

Health Insurance Waiver

A Belgian legal document allowing individuals to waive specific aspects of mandatory health insurance coverage, subject to Belgian healthcare regulations and EU requirements.

find out more

Insurance Waiver

A Belgian law-governed document where an insured party formally waives specific insurance rights or claims, compliant with Belgian insurance regulations and EU directives.

find out more

Accident Claim Form

A Belgian-law compliant Accident Claim Form for reporting incidents and seeking compensation, meeting local insurance and civil law requirements.

find out more

Medical Claim Form

A Belgian-compliant medical claim form for requesting reimbursement of healthcare expenses within the Belgian healthcare system.

find out more

Insurance Verification Form

A Belgian law-compliant form for official verification of insurance coverage details, meeting both national insurance regulations and EU data protection requirements.

find out more

Car Insurance Form

Belgian-law compliant car insurance contract template establishing vehicle coverage terms between insurer and policyholder.

find out more

General Liability Form

Belgian law-compliant General Liability Form establishing comprehensive liability management framework and risk allocation between parties.

find out more

Insurance Certificate Of Liability

A Belgian-compliant certificate confirming liability insurance coverage, detailing policy terms and coverage limits for third-party verification.

find out more

Group Insurance Form

A Belgian-law governed form establishing group insurance arrangements between employer, insurer, and employees, detailing coverage terms and administrative procedures.

find out more

Insurance Proposal Form

A Belgian-law governed insurance proposal form used to collect essential information for insurance coverage requests, complying with local insurance regulations and EU directives.

find out more

Insurance Cancellation Form

A Belgian-law compliant form for formal cancellation of insurance policies, including essential policyholder and policy information.

find out more

Insurance Declaration Form

A Belgian law-compliant form for declaring insurance-related information and risk factors, serving as the foundation for insurance policy issuance.

find out more

Insurance Affidavit

A sworn statement used in Belgian insurance matters, legally executed before a notary public and governed by Belgian insurance law.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: https://www.genieai.co/our-research
Oops! Something went wrong while submitting the form.

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our Trust Centre for more details and real-time security updates.

Read our Privacy Policy.