Motorcycle Insurance Claim

Date: [Date]

Policyholder Information

Name	[Your Name]
Policy Number	[Policy Number]
Email Address	[Your Email]

Incident Details

Date of Incident	July 15, 2024
Time of Incident	3:45 PM
Location of Incident	123 Main Street, Cityville, ST 12345
Description of Incident	The motorcycle was involved in a collision with another vehicle while making a left turn at an intersection. The other vehicle was at fault.
Police Report Number	PR1234567890
Police Department	Cityville Police Department

Motorcycle Information

Make	[Motorcycle Make]
Model	[Motorcycle Model]
Year	[Motorcycle Year]
VIN	[Vehicle Identification Number]

Damage Details

The following is a detailed list of the damages sustained by the motorcycle:

Front-wheel: Bent
Front fairing: Cracked
Right-side footpeg: Broken
Handlebars: Scratched

Estimated Repair Costs

Component	Repair Cost
Front-wheel	$300
Front fairing	$500
Right-side footpeg	$100
Handlebars	$200
Total Estimated Repair Costs	$1,100

Additional Notes

The motorcycle was towed to the repair shop immediately after the incident.
I am requesting expedited processing of this claim due to the urgent need for repairs to resume normal use of the motorcycle.

Attachments

Photos of damaged motorcycle
Repair estimate from Auto Repair Shop
Police report

Policy Holder Statement

I certify that the information provided in this claim is true and accurate to the best of my knowledge. I understand that any misrepresentation or falsification may result in the denial of this claim.