Claim Form

Pursuant to Article 32 of the Law of Ukraine "On Compulsory Motor Third Party Liability Insurance" (the "Law"), in order to receive a routine payment, an injured person or other person entitled to receive it shall submit the following documents to MTIBU:

1. a Claim Form (with the obligatory indication of information on mutual settlements and the existence of a voluntary property hull insurance contract) within a period not exceeding:

• one year from the date of the accident (in cases provided for in clause 4 of part one of Article 43 of this Law - from the date of termination of the insurer's membership in MTIBU) - if the damage was caused to the property of the injured person;
• three years from the date of the accident (in cases provided for in paragraph 4 of part one of Article 43 of this Law - from the date of termination of the insurer's membership in MTIBU) - if the damage is caused to the life or health of the injured individual.

2. Documents to be attached to the Claim Form:

1. a MTPL policy in force on the date of the accident or a certificate of the relevant privileged category (combatant, injured participant of the Revolution of Dignity, person with a disability of group I, person with a disability due to war, driving a vehicle belonging to them, as well as a person driving a vehicle belonging to a person with a disability of group I in his presence);
2. a passport of a citizen, or in case of its absence, another document that may be used to certify the applicant's identity in accordance with the legislation of Ukraine if the applicant is an individual;
3. a certificate of assignment of a taxpayer identification number to the recipient of funds (if assigned), if the applicant is an individual;
4. a document confirming the ownership of the damaged property as of the day of the road traffic accident (in case of the applicant's claim for compensation for damage to property);
5. a document certifying the applicant's right to receive insurance indemnity (power of attorney, lease agreement, certificate of inheritance), if the applicant is not the victim or his/her legal representative;
6. death certificate of the victim (if the applicant claims compensation for damage related to the victim's death);
7. documents confirming the victim's burial expenses (if the applicant claims reimbursement for the victim's burial expenses);
8. documents confirming the dependency of the victim, his or her income for the previous calendar year (before the accident), the amount of pensions granted to dependents as a result of the loss of the breadwinner (in case of a claim for compensation for damage due to the death of the breadwinner);
9. information on the applicant's bank details.

The accident report is filled in by the driver involved in the accident

If necessary, you can attach additional documents to the routine case already opened by the MTIBU here or in the victim's office. To do this, you need to know the case number

A service for conveniently filling in the application form, attaching additional documents, applying an electronic digital signature (EDS) and sending it to MTIBU.  ATTENTION! Submission of the application and other documents using the above service is the official way of submitting documents to MTIBU and does not require duplication in any other way (e-mail, mail).

In connection with the introduction of martial law in Ukraine temporarily, for the period of martial law, in order to promptly process incoming correspondence, Motor (Transport) Insurance Bureau of Ukraine strongly recommends that all persons applying to MTIBU for routine payments use electronic communication services and send Clime Forms, Accident Statements and other documents related to routine payments by means of electronic document submission service or to the MTIBU email address: [email protected]. Please note that in this case, the submitted documents must be signed with an electronic digital signature (EDS). In the absence of such a signature, the submitted documents will be considered as not meeting the requirements of Article Z5 of the Law of Ukraine " On Compulsory Motor Third Party Liability Insurance".

If you are unable to sign the EDS documents, they should be sent by post to MTIBU address: 8 Rusanivskiy blvd., Kyiv, Ukraine, 02653. We remind you that in accordance with the requirements of Article 35 of the Law of Ukraine " On Compulsory Motor Third Party Liability Insurance", in this case they must be submitted in copies certified by the applicant or a duly executed copy.

Please note that, the driver of the vehicle involved in the road traffic accident, the person entitled to receive compensation (the victim) are obliged to assist MTIBU in investigating the causes and circumstances of the road traffic accident, namely provide the vehicle or other damaged property owned by them for inspection, notify MTIBU of all circumstances known to them and provide the documents available to them regarding the road traffic accident for inspection and copying within seven business days from the date of receipt of the relevant information or document. If the said persons were unable to perform these actions for valid reasons, they must confirm this in writing.

IMPORTANT!

In some cases, MTIBU may request additional documents in order to establish all the circumstances of the accident, determine the degree of fault of the parties involved and determine the amount of damage.

PLEASE INDICATE CONTACT DETAILS IN YOUR CLAIMS AND NOTIFICATIONS TO SPEED UP THE CLAIMS SETTLEMENT PROCESS!

WARNING!

In case of providing deliberately false information, MTIBU may take measures to recover the unlawfully paid compensation in accordance with the current civil legislation of Ukraine, as well as to bring to criminal liability.

IMPORTANT!

Entering an email address in the Accident Statements allows access to the Personal Account of the Victim, an information environment through which a person who has applied to MTIBU for a routine payment from the centralised insurance reserve fund for the protection of victims can track the status of the settlement of his or her case, view documents attached to the case, and have direct communication with the person responsible for the settlement of the case at MTIBU.

After registering the case with MTIBU, a message will be sent to the specified email address, which will provide a link (link) to direct access to the case file, as well as an access code to the victim's account. The specified code must be entered when entering the account through the MTIBU website.

The email address provided by the Victim will also be automatically sent informational messages about changes in the status of the case and about the attachment of new documents to the case file.