Fast Track Claim Form

Personal Details
Details of Damage/Loss
Declaration & Signature

Personal Details

Insured's Name *

Insured's Name

First

Last

Email Address *

Telephone Number

Cell Number *

Risk Address *

Risk Address

City

Province

Postal Code

If you are human, leave this field blank.

Start Over

Memberships

Quick Links

Home
About us
Assist App
Products
Claim Forms
Contact us

Home
About us
Assist App
Products
Claim Forms
Contact us

Find Us

Phone: +27 21 762 5007

Lyall Morgan & Associates (Pty) Ltd.
132 Rosmead Avenue, Kenilworth 7745

PAIA Manual | Request to access records form | Privacy Policy

We are using cookies to give you the best experience on our website.

You can find out more about which cookies we are using or switch them off in .

Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

Enable or Disable Cookies

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.

Facebook Pixels

This website uses Facebook Pixels to collect anonymous information such as the number of visitors to the site, and the most popular pages.

Keeping this cookie enabled helps us to improve our website.

Enable or Disable Cookies

Please enable Strictly Necessary Cookies first so that we can save your preferences!