Claim Form

For registration of a claim as provided for in ESMA Agreements or other agreements, kindly complete the form and click the Claim button below.


    Full Name of Claimant / Representative of Claimant *

    Email of Claimant / Representative of Claimant *

    Claimant Company / Organisation Name *

    Claimant Company / Organisation Phone Number *

    Claimant Company / Organisation Address *

    Short Details of the Claim *

    Prospective Clients can also make contact with us direct at for further information and assistance with regard to the Application for the relevant "Ensurance" / Warranty Cover. Prospective Clients will be required to complete a confidential questionnaire and Due Diligence process, after which accreditation will take place and Clients will be provided with indicative terms and conditions for consideration by their decision-making bodies.