Insurance
Motor accident claim template
Reviewed against the Cooperative Insurance Companies Control Law — Regulator: Insurance Authority — Last reviewed: 6 November 2026
This template follows the law of Saudi Arabia, not the law of the United States or any other country. Naming the regulator identifies the law that applies; it does not mean the regulator approved this template. This is a general template and does not replace advice on your own case.
- 20 designs, Arabic and English
- Fill the blanks in your browser
- Print, or save as PDF or Word
- No account needed to start
Preview — Formal concise
Motor Accident Claim
Date: Date
To: Insurance Company
Please compensate me for damage to my vehicle, Vehicle Description, plate Plate Number, insured under policy No. Policy Number, following an accident on Accident Date at Accident Place, under Najm report No. Najm Report Number. Damage: Damage Description.
Policyholder Name – Mobile