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Liability Claim Form

Please complete this form to notify Webber Insurance of your claim. We use this form in place of a paper form to submit to the insurers to arrange the notification.
Please note that your information is saved on our server as you enter it, which will allow you to save and continue your form later on.
To save the form, please click the link at the bottom of this page.

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  • Your Details


  • Third Party Details


  • Details of Loss


  • Type of Loss


  • Regulatory &/or Other Authorities


  • Further Documentation

  • Drop files here or
    Max. file size: 32 MB.
      This includes Letters of Demand, correspondence from third parties, quotes for repairs, relevant contracts, agreements etc


    • Declaration


    • Signature

      This electronic signature will be treated the same as if signed personally.
    • Clear Signature
    • This field is for validation purposes and should be left unchanged.
    Save and Continue Later