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Vehicle Insurance Claim Form (Ghana)

Vehicle Insurance Claim Form (Ghana)

Vehicle Insurance Claim Form

VEHICLE INSURANCE CLAIM FORM

Submitted to [Insurer Name] pursuant to Section 40 of the Insurance Act 2006 (Act 724) and the National Insurance Commission (NIC) claims settlement requirements.

1. Policyholder and Policy Details

1.1

Policyholder: [Policyholder Name], of [Policyholder Address], Tel: [Policyholder Phone].

1.2

Insurance policy number: [Policy Number] | Insurer: [Insurer Name] | Policy expiry: [Policy Expiry Date].

2. Insured Vehicle

2.1

Vehicle: [Vehicle Make/Model], Year: [Year], DVLA Reg. No.: [DVLA Reg. No.], VIN: [VIN].

2.2

Driver at time of incident: [Driver Name], DVLA Licence No.: [Driver Licence No.].

3. Incident Details

3.1

Date: [Incident Date] | Time: [Incident Time] | Location: [Incident Location].

3.2

Type of claim: [Claim Type].

3.3

Description of incident: [Incident Description].

4. Police Report

4.1

Police report (MTTD) No.: [Police Report No.], dated [Police Report Date], obtained from: [Police Station].

6. Damage and Claim Amount

6.1

Damage description: [Damage Description].

6.2

Estimated claim amount: [Claim Amount] (GHS) | Preferred repairer: [Preferred Repairer].

7. Declaration

I, [Policyholder Name], hereby declare that the information provided in this claim form is true, accurate, and complete to the best of my knowledge and belief. I acknowledge the duty of utmost good faith (uberrimae fidei) applicable to all insurance contracts under Ghanaian insurance law and the Insurance Act 2006 (Act 724). I understand that providing false or misleading information may result in the rejection of this claim and may constitute an offence under the Insurance Act 2006 (Act 724) and the Revenue Administration Act 2016 (Act 915).

Date of submission: [Submission Date].

Signature

Signed by the policyholder on [Submission Date].

Policyholder

________________

Signature

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What Is a Vehicle Insurance Claim Form (Ghana)?

A Vehicle Insurance Claim Form in Ghana is a formal document submitted by a motor insurance policyholder to their insurer requesting payment of compensation for loss of or damage to a motor vehicle, or for third-party liability arising from a road traffic accident. The Vehicle Insurance Claim Form (Ghana) is the first step in the claims process regulated by the National Insurance Commission (NIC) under the Insurance Act 2006 (Act 724), which is the principal statute governing the insurance industry in Ghana.

The Insurance Act 2006 (Act 724) established the National Insurance Commission (NIC) as the regulatory and supervisory authority for insurance business in Ghana. Section 40 of the Insurance Act 2006 (Act 724) governs claims settlement procedures and requires insurers licensed by the NIC to settle valid claims within a reasonable time. The NIC monitors insurer solvency and compliance with policyholder protection obligations across all classes of insurance business in Ghana, including motor insurance.

The Motor Vehicles (Third Party Insurance) Act 1958 (Act 42) requires every motor vehicle operated on a public road in Ghana to be covered by a valid third-party motor insurance policy. Third-party coverage under Act 42 protects third parties — other road users, pedestrians, and their dependants — against death or bodily injury caused by the insured vehicle. Thorough motor insurance, which covers damage to the insured's own vehicle in addition to third-party liability, is not mandatory under Ghanaian law but is commercially available from insurers licensed by the NIC under the Insurance Act 2006 (Act 724).

The Road Traffic Act 2004 (Act 683) requires road traffic accidents to be reported to the Ghana Police Service. A police report from the Ghana Police Service is a standard document required by Ghanaian insurers to support a motor insurance claim, particularly for accident claims, theft claims, and third-party liability claims. The Motor Traffic and Transport Department (MTTD) of the Ghana Police Service investigates road traffic accidents and issues accident reports used in insurance claims processing.

The Alternative Dispute Resolution Act 2010 (Act 798) provides mechanisms for resolving insurance disputes outside the courts. The National Insurance Commission (NIC) also has a Consumer Affairs and Protection Unit that handles complaints from policyholders whose claims have been wrongly denied or unreasonably delayed by an insurer. Where an insurer fails to settle a valid claim within a reasonable time under Section 40 of the Insurance Act 2006 (Act 724), the policyholder may lodge a formal complaint with the NIC or commence action before the High Court (Commercial Division) in Accra.

The legal framework governing the Vehicle 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 Vehicle 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 Vehicle Insurance Claim Form (Ghana)?

A Vehicle Insurance Claim Form in Ghana is needed whenever a motor insurance policyholder wishes to make a claim against their insurance policy for a covered event involving their motor vehicle.

A Vehicle Insurance Claim Form is required when a policyholder's vehicle is damaged in a road traffic accident on Ghanaian roads — including the N1 Highway in Greater Accra, the Accra-Kumasi Highway (N6), or any urban or rural road across Ghana's sixteen administrative regions. The claim form must be submitted promptly to the insurer within the notification period specified in the policy, typically within seven to twenty-one days of the accident, to avoid the insurer rejecting the claim for late notification.

A Vehicle Insurance Claim Form is needed when a motor vehicle is stolen or when vehicle parts or accessories are stolen from a parked vehicle. The policyholder must report the theft to the Ghana Police Service and obtain a police report from the Motor Traffic and Transport Department (MTTD) before submitting the claim form to the insurer.

A Vehicle Insurance Claim Form is required when a third party makes a claim against a policyholder for damage to the third party's vehicle or property, or for personal injury suffered by the third party, arising from an accident involving the policyholder's vehicle. The policyholder must notify the insurer of the third-party claim immediately and provide the claim form and police report to allow the insurer to investigate and respond to the third party's claim under the Motor Vehicles (Third Party Insurance) Act 1958 (Act 42).

A Vehicle Insurance Claim Form is needed when a vehicle sustains damage from causes other than a road traffic accident — such as fire, flood, falling trees, vandalism, or civil disturbance — where the policyholder holds a thorough motor insurance policy with appropriate coverage for these additional perils.

A Vehicle Insurance Claim Form is required when a corporate policyholder — such as a company incorporated under the Companies Act 2019 (Act 992) or a government ministry, department, or agency — submits a fleet insurance claim following damage to or loss of a vehicle from its insured fleet.

What to Include in Your Vehicle Insurance Claim Form (Ghana)

A complete Vehicle Insurance Claim Form submitted to an NIC-licensed insurer in Ghana under the Insurance Act 2006 (Act 724) must contain the following essential information.

Policyholder Details: Full name of the insured as stated on the insurance policy, policy number, contact address, telephone number, and Tax Identification Number (TIN) issued by the Ghana Revenue Authority (GRA) under the Revenue Administration Act 2016 (Act 915) where applicable for corporate policyholders.

Vehicle Details: Make, model, year of manufacture, DVLA registration number, vehicle identification number (VIN or chassis number), engine number, and colour of the insured vehicle. These must match the details in the insurance certificate issued by the NIC-licensed insurer.

Incident Details: Date, time, and precise location of the incident — including the name of the road, town, and administrative region; description of the circumstances of the loss or damage; and the nature of the claim (accident damage, theft, fire, flood, third-party liability, etc.).

Police Report: Reference number and date of the police report issued by the Motor Traffic and Transport Department (MTTD) of the Ghana Police Service. A police report is required for accident claims, theft claims, and all third-party liability claims under standard policy conditions applied by NIC-licensed insurers in Ghana.

Third-Party Details (if applicable): Names, contact addresses, vehicle registration numbers, and insurance details of all other parties involved in the accident. Witness names and contact details should also be recorded.

Damage Description: A detailed description of the damage sustained by the insured vehicle, including which parts are damaged, estimated repair costs, and the name and address of the proposed repairer (panel beater or authorised service centre).

Claim Amount: The amount claimed by the policyholder, supported by repair quotations, valuation reports, or replacement cost estimates as required by the insurer. Where the vehicle is a total loss, an independent valuation from a licensed motor vehicle assessor may be required.

SupportingDocuments: Copies of the insurance certificate and policy schedule, vehicle registration certificate (logbook) from the DVLA, DVLA roadworthiness certificate, valid driving licence of the driver at the time of the incident, police accident report, and photographs of the damage.

Declaration: A signed declaration by the policyholder confirming that the information provided is true and complete, consistent with the duty of utmost good faith (uberrimae fidei) applicable to all insurance contracts under Ghanaian insurance law.

Forms-legal.com provides this Vehicle Insurance Claim Form as a preparation tool for policyholders in Ghana. Policyholders with disputed or complex claims should consult an insurance broker registered with the NIC or a solicitor enrolled with the Ghana Bar Association.

Additional compliance elements for a Vehicle 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.

Under Section 40 of the Insurance Act 2006 (Act 724), insurance companies operating in Ghana must process valid motor vehicle claims within the timeframes prescribed by the National Insurance Commission (NIC). Section 183 of the Road Traffic Act 2004 (Act 683) mandates that every motor vehicle registered with the Driver and Vehicle Licensing Authority (DVLA) must carry a valid third-party insurance policy at minimum. Section 42 of Act 724 grants the NIC supervisory authority over all claims settlement practices, requiring insurers to maintain adequate reserves for pending motor vehicle claims. The forms-legal.com vehicle insurance claim template for Ghana incorporates fields aligned with these statutory obligations, referencing Section 184 of Act 683 regarding accident reporting requirements and Section 45 of Act 724 concerning documentation standards for claims adjudication by licensed loss adjusters registered with the NIC under Section 61 of Act 724.

Sources & Citations

Statutory citations link to official government sources.

  1. Marriages Ordinance (Cap. 127)HK official

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Vehicle Insurance Claim Form (Ghana) (Ghana) [Legal document template]. Forms Legal. https://forms-legal.com/ghana/personal/insurance/vehicle-insurance-claim-ghana

MLA

"Vehicle Insurance Claim Form (Ghana) (Ghana)." Forms Legal, 2026, https://forms-legal.com/ghana/personal/insurance/vehicle-insurance-claim-ghana.

BibTeX
@misc{formslegal-vehicle-insurance-claim-ghana,
  author       = {{Forms Legal}},
  title        = {Vehicle Insurance Claim Form (Ghana) (Ghana)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/ghana/personal/insurance/vehicle-insurance-claim-ghana}},
  note         = {Free legal document template}
}

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Frequently Asked Questions

Statute-referenced template — Template last modified June 2026

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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