Motor Insurance Claim Form (Ghana)
Motor Insurance Claim Form
MOTOR INSURANCE CLAIM FORM submitted pursuant to Section 40 of the Insurance Act, 2006 (Act 724) and the Motor Vehicles (Third Party Insurance) Act, 1958 (Act 42).
Date of Claim Form: [Claim Date]
1. Policy and Policyholder Details
Policyholder Name: [Policyholder Name]
Address: [Policyholder Address]
Contact Number: [Policyholder Phone]
Insurance Company: [Insurer Name] (NIC-licensed insurer)
Policy Number: [Policy Number] | Class of Cover: [Policy Class] | Policy Period: [Policy Period]
2. Vehicle Details
Vehicle Make and Model: [Vehicle Make Model] | Year: [Vehicle Year]
DVLA Registration Number: [Registration Number]
Chassis / VIN Number: [Chassis Number] | Engine Number: [Engine Number]
3. Incident Details
Date of Incident: [Incident Date] | Time: [Incident Time]
Location: [Incident Location]
Type of Incident: [Incident Type]
Description of Incident: [Incident Description]
Ghana Police MTTD Report Number: [Police Report Number]
4. Third Party Details
Third Party Name: [Third Party Name]
Third Party Vehicle Registration: [Third Party Vehicle Reg] | Third Party Insurer: [Third Party Insurer]
5. Claim Details
Nature of Claim: [Claim Type]
Estimated Total Loss / Repair Cost: GHS [Estimated Loss]
6. Declaration
I, [Policyholder Name], declare that the information provided in this Motor Insurance Claim Form is true, complete, and accurate to the best of my knowledge. I authorise [Insurer Name] to obtain information from the Ghana Police Service, the Driver and Vehicle Licensing Authority (DVLA), and any medical practitioner in connection with this claim. I acknowledge that making a false or fraudulent claim is an offence under the Criminal Offences Act, 1960 (Act 29) and constitutes grounds for cancellation of my insurance policy under the Insurance Act, 2006 (Act 724).
Policyholder
________________
Signature
What Is a Motor Insurance Claim Form (Ghana)?
A Motor Insurance Claim Form in Ghana records the particulars required for the matter it documents.
Section 40 of the Insurance Act, 2006 (Act 724) requires insurers licensed by the National Insurance Commission (NIC) to settle valid claims within 90 days of receipt of all required documentation. The NIC, established under Part I of Act 724, supervises all insurance companies in Ghana, sets minimum capital requirements, and handles complaints from policyholders against insurers. All motor insurers operating in Ghana must be registered with the NIC and must be members of the Ghana Insurers Association (GIA).
The Motor Vehicles (Third Party Insurance) Act, 1958 (Act 42) makes it a criminal offence under Section 1 to use or permit the use of a motor vehicle on a road in Ghana without a valid third-party insurance policy. The DVLA (Driver and Vehicle Licensing Authority), established under the Road Traffic Act, 2004 (Act 683), requires proof of a valid NIC-registered insurance certificate before issuing a road worthiness certificate or renewing a vehicle licence. The Ghana Police Service Motor Traffic and Transport Department (MTTD) enforces the compulsory insurance requirement at checkpoints throughout Ghana's 16 administrative regions.
A Motor Insurance Claim Form in Ghana must be distinguished from a Police Accident Report (Form 11), which is the official police record of a road traffic accident prepared by the MTTD, and from a Motor Vehicle Inspection Report, which is a technical assessment of vehicle damage prepared by an approved assessor. The claim form initiates the insurer's internal claims process, whereas the police report and inspection report are evidence submitted in support of the claim. Under Act 724, insurers may not unreasonably withhold settlement once valid documentation is submitted.
The legal framework governing the Motor Insurance Claim Form (Ghana) includes the Insurance Act 2006 (Act 724), the Motor Vehicles (Third Party Insurance) Act 1958 (Act 42), the Road Traffic Act 2004 (Act 683), the National Insurance Commission (NIC) Guidelines on Claims Settlement, and the Motor Insurance Bureau of Ghana (MIB) rules applicable to claims against uninsured drivers. Disputes between policyholders and insurers in Ghana are referred to the NIC Insurance Complaints Bureau or, for amounts exceeding its jurisdiction, to the High Court (Commercial Division) in Accra.
The legal framework governing the Motor Insurance Claim Form (Ghana) in Ghana draws on several key statutes and regulatory bodies. Under Ghanaian law, the Data Protection Act 2012 (Act 843) and the Data Protection Commission govern personal data processing. The Marriages Act 1884-1985 (Cap. 127) and Marriages Ordinance (Cap. 127) govern civil marriages. The Intestate Succession Law 1985 (PNDC Law 111) overrides customary succession for specified relatives. The Courts Act 1993 (Act 459) governs court procedures. The Children's Act 1998 (Act 560) governs child welfare. Parties executing a Motor Insurance Claim Form (Ghana) in Ghana should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Insurance Act 2006 (Act 724) sets the foundational requirements.
When Do You Need a Motor Insurance Claim Form (Ghana)?
A Motor Insurance Claim Form in Ghana is required whenever a policyholder wishes to formally notify an NIC-licensed insurer of an event covered under their motor insurance policy and seek indemnification.
A Motor Insurance Claim Form is required immediately after a road traffic accident in Ghana involving damage to the insured vehicle, personal injury, or damage to third-party property. Under Section 40 of the Insurance Act, 2006 (Act 724), most motor insurance policies require notification within 24 to 48 hours of the accident. Late notification can prejudice the claim, and insurers licensed by the NIC may rely on a late-notification condition to reduce or refuse indemnity.
A Motor Insurance Claim Form is needed when a vehicle insured under a thorough motor policy has been stolen in Ghana. The policyholder must notify the Ghana Police Service Motor Traffic and Transport Department (MTTD) immediately, obtain a police extract (Police Form 11), and submit the claim form to the insurer within the period specified in the policy schedule.
A Motor Insurance Claim Form is required after a fire, flood, or other peril covered under a thorough policy causes damage to the insured vehicle. The insurer will appoint an approved motor assessor registered with the Ghana Insurers Association (GIA) to inspect and value the damage before authorising repairs at a panel-beating workshop.
A Motor Insurance Claim Form is needed when a third party (another road user, pedestrian, or property owner) makes a demand against the policyholder for compensation arising from a road traffic accident in Ghana. The policyholder must notify the insurer promptly and forward all third-party correspondence to enable the insurer to conduct the defence or negotiate settlement under the Motor Vehicles (Third Party Insurance) Act, 1958 (Act 42).
A Motor Insurance Claim Form is required by fleet operators — companies operating multiple commercial vehicles on Ghanaian roads — when any vehicle in the fleet is involved in an incident. Fleet policies issued by NIC-licensed insurers typically require the fleet manager to complete a standardised claim notification form within 48 hours of any incident.
Parties in Ghana should prepare a Motor Insurance Claim Form (Ghana) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Ghanaian law, the Data Protection Act 2012 (Act 843) and the Data Protection Commission govern personal data processing. The Marriages Act 1884-1985 (Cap. 127) and Marriages Ordinance (Cap. 127) govern civil marriages. The Intestate Succession Law 1985 (PNDC Law 111) overrides customary succession for specified relatives. The Courts Act 1993 (Act 459) governs court procedures. The Children's Act 1998 (Act 560) governs child welfare. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.
What to Include in Your Motor Insurance Claim Form (Ghana)
A valid Motor Insurance Claim Form in Ghana under the Insurance Act, 2006 (Act 724) and NIC claims-settlement guidelines must contain the following essential elements.
Policyholder and Policy Details: Full legal name of the policyholder, National Identification Authority (NIA) Ghana Card number or passport number, contact address and telephone number, the insurance policy number, the name of the NIC-licensed insurer, the policy period, and the class of cover (third-party only, third-party fire and theft, or thorough) under the policy schedule issued pursuant to Act 724.
Vehicle Details: Make, model, year of manufacture, colour, engine number, chassis number, and the vehicle registration number assigned by the Driver and Vehicle Licensing Authority (DVLA) under the Road Traffic Act, 2004 (Act 683). The roadworthiness certificate number and expiry date must also be provided.
Description of the Incident: Date, time, and exact location of the accident or loss event (identified by road name, town, and region in Ghana), direction of travel, weather and road conditions at the time of the incident, and a narrative description of how the accident occurred. The description must align with the statement given to the Ghana Police Service Motor Traffic and Transport Department (MTTD) on Police Form 11.
Third-Party Details: Where applicable, the name, address, vehicle registration number, and insurer of any third party involved in the accident, together with the names and contact details of independent witnesses. This information is required for the insurer to exercise subrogation rights against the third party's insurer under Act 724.
Police Report Reference: The MTTD police report number and the name of the police station that attended the scene or accepted the report, as required by most NIC-licensed insurers before processing a claim under thorough or third-party policies.
Nature of Claim and Estimated Loss: A statement of the type of claim (repair costs, total loss, theft, personal injury, third-party property damage), supported by a preliminary estimate of the loss value in Ghana Cedis (GHS).
Declaration and Signature: A signed declaration by the policyholder confirming that the information is true and complete, authorising the insurer to obtain information from the Ghana Police Service, DVLA, and any medical practitioner, and acknowledging that making a fraudulent claim is an offence under the Criminal Offences Act, 1960 (Act 29) and grounds for policy cancellation under Act 724.
The forms-legal.com Motor Insurance Claim Form (Ghana) template covers all mandatory elements under Act 724 and NIC guidelines and includes a checklist of supporting documents: police extract, DVLA registration certificate, roadworthiness certificate, driver's licence, repair estimate, and photographs of the damaged vehicle. Policyholders should also refer to a Motor Vehicle Bill of Sale (Ghana) when the vehicle has recently changed ownership to confirm insurable interest.
Additional compliance elements for a Motor Insurance Claim Form (Ghana) used in Ghana include: Under Ghanaian law, the Data Protection Act 2012 (Act 843) and the Data Protection Commission govern personal data processing. The Marriages Act 1884-1985 (Cap. 127) and Marriages Ordinance (Cap. 127) govern civil marriages. The Intestate Succession Law 1985 (PNDC Law 111) overrides customary succession for specified relatives. The Courts Act 1993 (Act 459) governs court procedures. The Children's Act 1998 (Act 560) governs child welfare. Forms-legal.com provides this template as a starting point for Ghana-compliant documentation.
Sources & Citations
Statutory citations link to official government sources.
- Marriages Ordinance (Cap. 127)HK official
Cite this page
Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Motor Insurance Claim Form (Ghana) (Ghana) [Legal document template]. Forms Legal. https://forms-legal.com/ghana/personal/insurance/motor-insurance-claim-form-ghana
"Motor Insurance Claim Form (Ghana) (Ghana)." Forms Legal, 2026, https://forms-legal.com/ghana/personal/insurance/motor-insurance-claim-form-ghana.
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Under Section 40 of the Insurance Act, 2006 (Act 724), an insurer licensed by the National Insurance Commission (NIC) in Ghana must settle a valid insurance claim within 90 days of receiving all required documentation from the policyholder. Where the insurer disputes liability or requires further investigation, it must notify the claimant in writing within 30 days of receiving the claim form, setting out the reasons for delay. Failure to settle within 90 days entitles the policyholder to complain to the NIC Insurance Complaints Bureau, which has jurisdiction to order payment and impose penalties on non-compliant insurers. In practice, straightforward claims with a complete police report, approved assessor's report, and all supporting documents are often settled within 30 to 45 days by insurers that are members of the Ghana Insurers Association (GIA).
Motor insurance is compulsory in Ghana under the Motor Vehicles (Third Party Insurance) Act, 1958 (Act 42), which requires every owner or user of a motor vehicle on a public road in Ghana to hold a valid third-party insurance policy issued by an insurer licensed by the National Insurance Commission (NIC). The minimum mandatory cover indemnifies third parties (other road users, pedestrians, and property owners) against bodily injury and property damage caused by the insured vehicle. The Driver and Vehicle Licensing Authority (DVLA) requires proof of valid NIC-registered motor insurance before issuing or renewing a vehicle licence or roadworthiness certificate. Driving without valid insurance is a criminal offence under Act 42, punishable by a fine and imprisonment. The Motor Insurance Bureau of Ghana (MIB) provides compensation to victims of accidents caused by uninsured or untraced drivers in Ghana, funded by contributions from all NIC-licensed motor insurers.
To support a motor insurance claim in Ghana under the Insurance Act, 2006 (Act 724), a policyholder must typically submit: the completed Motor Insurance Claim Form signed by the policyholder; a copy of the insurance policy certificate and schedule; the Ghana Police Service Motor Traffic and Transport Department (MTTD) accident report or police extract (Police Form 11); a copy of the DVLA vehicle registration certificate; the current roadworthiness certificate; the driver's licence of the person driving at the time of the accident; photographs of the damaged vehicle and the accident scene; an approved vehicle assessor's damage report and repair estimate; and, for theft claims, proof of ownership and a police report confirming the theft was reported. Insurers licensed by the NIC may require additional documents, including medical reports for personal injury claims and repair invoices from an authorised panel-beating workshop.
If a motor insurance claim in Ghana is rejected by an NIC-licensed insurer, the policyholder has several remedies. First, the policyholder may request a written explanation of the rejection from the insurer, citing the specific policy condition and the provisions of the Insurance Act, 2006 (Act 724) relied upon. Second, the policyholder may lodge a formal complaint with the National Insurance Commission (NIC) Insurance Complaints Bureau, which investigates disputes between policyholders and insurers and can direct the insurer to settle a valid claim. Third, for claims involving significant amounts, the policyholder may commence proceedings in the High Court (Commercial Division) in Accra. Engaging a solicitor enrolled with the Ghana Bar Association who specialises in insurance law is advisable before pursuing court proceedings. The NIC can also revoke an insurer's licence for persistent failure to honour valid claims.
Making a motor insurance claim in Ghana under a detailed policy issued by an NIC-licensed insurer may affect the policyholder's no-claims discount (NCD) at renewal. Most motor insurers in Ghana apply a no-claims bonus system: policyholders who do not make a claim in a policy year are entitled to a premium discount of 10–25% at renewal, depending on the insurer's tariff filed with the National Insurance Commission (NIC). A claim — particularly one where the policyholder is at fault — will typically reduce or eliminate the no-claims discount and may result in a higher renewal premium. The Ghana Insurers Association (GIA) has issued guidelines on the application of no-claims bonuses to promote uniformity among NIC-licensed motor insurers. Policyholders should review their policy schedule and the NCD provisions with their broker before deciding whether to claim for minor damage that costs less than the premium loading that would result.
The Motor Insurance Bureau of Ghana (MIB) operates under an agreement with the Government of Ghana and the National Insurance Commission (NIC) to provide compensation to victims of road traffic accidents in Ghana caused by uninsured drivers or untraced (hit-and-run) vehicles, where no NIC-licensed insurer is available to meet the claim. The MIB is funded by compulsory levies on all motor insurers in Ghana. A victim who cannot recover from an insurer must first make a report to the Ghana Police Service Motor Traffic and Transport Department (MTTD), obtain a police extract, and then apply to the MIB with full documentation of the accident and loss. The MIB does not handle claims that can be met by a licensed insurer under the Motor Vehicles (Third Party Insurance) Act, 1958 (Act 42). Claims submitted to the MIB are assessed under its standard procedures and are subject to the same documentation requirements as a standard motor insurance claim.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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