Veloce Auto Group

I am…The Customer / Accident VictimAn Attorney's OfficeA Business

Contact

Only first name, last name, phone and email are required. Everything else may be left blank.

First nameLast namePhoneEmailDate of birthBest time to callAddressLanguageWhich language you would like us to call you in.

ID & insurance

Any form of ID, and the policies on both sides if you have them.

ID typeNot everyone has a driver's license.ID numberStatePut N/A if your ID has no issuing state.ID expirationInsurance carrierPolicy numberOther driver's carrierOther driver's policy numberClaim numberIf one has been opened.

Is the other driver's insurance confirmed at fault?YesNoPending

The accident

What happened, and where the vehicle is now.

Date of accidentPolice report numberOptional.What happened

Is the vehicle drivable?YesNo

Was it towed?YesNo

Tow company or storage lotOptional — but it is charged by the day, so it is worth telling us.

The rental

When you need it, and how you would like it.

From whenWhat kind of carOr tell us what you normally drive.Collect or deliveredDelivery addressIf delivered.

How the rental vehicle will be covered

Every rental has to be covered before it leaves. Tell us which applies — we'll confirm the details before pickup.

Own policy covers it.Comprehensive and collision — full coverage — extending to a rental vehicle at no extra cost.Proof of coverage at pickup.Coverage details will be provided when the vehicle is collected.Coverage through Veloce is needed.Please discuss the details with the client or their attorney.Not sure — please call.

Damage Waiver

Optional. Covers damage to the rental vehicle that a policy does not. A daily charge applies — we'll confirm the amount before signing.

Yes, I would like itNoExplain it first

Veloce Additional Services

Optional. Tick anything you’d like us to handle alongside the rental.

Diminished Value Claim AssistanceProperty Damage Claim HandlingTowing / Storage Fee RecoveryLoss of Use ClaimFull-Service PackageBundles the four above.

Who's Applying

Contact

ID & insurance

The accident

The rental