Car Claims Form - Fire

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About your Vehicle Claim (Fire)

Please enter the date in the format dd/mm/yyyy

Please insert as 24 hour (e.g 13:52)

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Please describe what happened before and during the fire

Did you see any dashboard warning lights before the fire? (e.g., engine, oil pressure)
Do you know what caused the fire?
Were there any personal belongings in the vehicle?

Additional Details (to help us process the claim faster)

Did the Fire Brigade attend?
Did the Gardai attend?
Was anybody injuried?
Do you give permission for our investigator to contact you?
Do you give permission for your vehicle to be inspected?
Is there any CCTV in the surrounding area?

Vehicle Details

Is there finance on the vehicle?
Are you aware of any product recalls or warranty issues for this vehicle?

Aviva Customer Details

Policy Number

Are you the policy holder?

Optional – only complete if you're not the Policyholder

If you're notifying this claim on behalf of an Aviva customer, please provide your details below:

Please specify your relationship to the policyholder.

If you submit this form outside our normal working hours, we may have team members available from 8am on the next working day.

Please confirm below if you consent to Aviva contacting you between 8am and 9am if staff are available

Claim Documentation

If you wish to send an attachment (photos, estimates, or claim documentation) with your message, please submit the form, then email the attachment directly to us at motorclaimsireland@aviva.com

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