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Defendant only claim notification

Document Cited authorities 4 Cited in Related
Vincent
Published date21 March 2018
Subject MatterRoad Traffic Act personal injury forms
1
Claimant’s representative - contact details
Name
Address
Contact name
Telephone number
E-mail address
Reference number
Defendant’s details
Defendant’s name
Defendant’s address*
Defendant’s vehicle registration number
Policy number reference
Insurer name
Date sent / /
RTA2 Claim notication form (defendant only) (04.13)
Postcode
Defendant only
Claim notication form(RTA2)
Low value personal injury claims in
road trac accidents(£1,000 - £25,000)
Before lling in this form you are encouraged to seek independent legal advice.
Postcode
Items marked with (*) are optional and the claimant must make a reasonable attempt to complete those boxes.
All other boxes on the form are mandatory and must be completed before being sent.
A copy of this form has been sent to your insurer, the claimant’s date of
birth and national insurance number has been omitted.
Please tick here if you are not legally represented? If you are not legally represented please put your details in the
claimant’s representative section.
What is the value of your claim? up to £10,000 up to £25,000

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