Step 1

Register Claim

Please complete the fields below and click 'Submit'. Note: "mandatory" denotes a mandatory field.

If you include an email address and tick the box next to each claim form you require, the forms will be emailed immediately.

Please check your spam/junk folders and add us (info@reactiveclaims.com) to your contact list!

All dates should be entered in the "dd/mm/yyyy" format. You can enter the date manually, select from the drop-down calendar or use a combination of the 2 methods.

Title:mandatory
First name:mandatory
Surname:mandatory
Postcode lookup:mandatory  
Choose address:mandatory
Address Line 1:mandatory
Address Line 2:mandatory
Town:mandatory
County:mandatory
Postcode:mandatory
Date of Birth:mandatory  (dd/mm/yyyy)
Telephone No.:mandatory
Mobile number:mandatory
Email address:mandatory
Confirm Email address:mandatory
Policy Purchase Date:mandatory  (dd/mm/yyyy)
Policy Start date:mandatory  (dd/mm/yyyy)
Policy End Date:mandatory  (dd/mm/yyyy)
Departure Date:mandatory  (dd/mm/yyyy)
Return Date:mandatory  (dd/mm/yyyy)
 spacerSubmit button is at the bottom of the page.

 

Step 2

Place a checkmark next to the Claim Forms you need and, if you have entered a valid email address above, we will email the Claim Forms to you for completion.

Step 3

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