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LIBERTY INSURANCE BROAD (16688K) (formerly known as Uni. Asia General Insurance Broad) 9th Floor, Menard Liberty, 1008 Japan Sultan Ismail, 50250 Kuala Lumpur, Malaysia. Tel : 03 2619 9000 Fax : 03
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Read the instructions carefully before starting to fill out the form.
02
Enter the basic personal information such as your name, address, and contact details.
03
Provide details about the incident, including the date, time, and location.
04
Describe the circumstances of the incident, such as what happened and who was involved.
05
Include any relevant supporting documents or evidence, such as photographs or witness statements.
06
If there were any injuries or damages, make sure to document them accurately.
07
Provide information about your insurance policy and coverage.
08
Indicate whether you have already reported the incident to the authorities or your insurance company.
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Review and double-check all the information you have entered to ensure accuracy.
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Sign and date the form, and make a copy for your records before submitting it.

Who needs motorist companion proposal form?

01
Anyone involved in a motor vehicle accident can benefit from filling out a motorist companion proposal form.
02
This form is particularly useful for individuals who want to file a claim with their insurance company or seek legal assistance.
03
It is also recommended for those who need to provide detailed information about the incident for future reference or investigations.
04
Whether you were a driver, passenger, or pedestrian involved in an accident, filling out this form can help ensure that all relevant information is documented.
05
Both the responsible party and the injured party may need to fill out this form to facilitate the claims process and determine liability.
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Motorist companion proposal form is a document that allows individuals to propose a companion who will accompany them during their journey.
Individuals who require assistance during their travel due to medical or other reasons are required to file motorist companion proposal form.
To fill out motorist companion proposal form, individuals need to provide information about themselves, their proposed companion, reasons for needing assistance, and details of the journey.
The purpose of motorist companion proposal form is to ensure that individuals who require assistance during their journey have a companion to support them.
Information such as personal details of the individual, details of the proposed companion, reasons for needing assistance, and details of the journey must be reported on motorist companion proposal form.
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