windscreen damage claim Please enable JavaScript in your browser to complete this form.Insured Policy Number *Identity Number / Registration Number *Contact Number *Driver And Vehicle Name of Driver *FirstLastContact Number of Driver *Vehicle Make *Eg. BMW, Ford Model *Eg. 320i, Ranger Year of Manufacture Vehicle Registration Number *Details Date of Loss *State How Breakage Occurred *Nature of Damage *Eg. Chip, CrackGlazier *By Submitting This I Agree That The Foregoing Particulars To Be True In Every Respect *I AgreeSignature Clear Signature Submit Quick Links Products About Us Get a Quote Claims Download/Submit Forms Claim Online Contact Us Contact Us (031) 336 9400 info@wwib.co.za Santoni House Westwood Insurance Brokers (Pty) Ltd is an authorised financial services provider | FSP No.: 16726 Linkedin