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You
Accident
Vehicle
3rd Party
Injuries
Done
Please answer all highlighted questions before continuing.
Your Details
Personal information and claim type
Claimant Details
Driving Licence
Home Address
Accident Details
Tell us about the incident
Time, Location & Description
Your Vehicle
Vehicle details, insurance & hire
DVLA Vehicle Details
Fuel Type
Tax Status
MOT Status
Engine
Tax Due
MOT Expiry
Supporting Documents
📎
Click to upload or drag & drop files here
Photos, dashcam, PDF, Word — max 20MB each
Defendant & Witnesses
Third party and witness information
Defendant Details
Defendant's Vehicle
DVLA Vehicle Details
Fuel Type
Tax Status
MOT Status
Engine
Tax Due
MOT Expiry
Witness Details
If there were any witnesses to the accident, please provide their details below. Leave blank if no witnesses.
Injuries & Declaration
Injury details and final submission
Passenger Claims
Accident History
Important — Please Read Carefully

You must provide details of all previous and subsequent accidents you have had, whether fault or non-fault, even if you did not make a claim. This includes road traffic accidents, accidents at work, slips and trips, and any other type of accident.

If you fail to disclose your full accident history you will be in breach of your CFA (No Win No Fee Agreement), in which PTH Claims reserve the right to terminate the agreement and seek to recover costs from you. The courts may also impose a custodial sentence as this may be seen as fundamental dishonesty.

Final Details

I confirm that the information provided in this form is accurate and complete to the best of my knowledge. I authorise PTH Claims to process my claim on my behalf and to communicate with relevant third parties as required. I understand that providing false information may affect my claim.

Claim Submitted!

PTH-XXXXXX

Thank you for submitting your claim. One of our specialists will review your details and be in touch within 2 hours. Please keep your reference number safe.

Urgent? Call 0121 516 6441
Step 01
We review your claim details within 2 hours.
Step 02
Our specialist contacts you to confirm next steps.
Step 03
We manage your claim from start to finish, no win no fee.
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