Lodge a claim

INSURED DETAILS

GST

CLAIM PAYMENT DETAILS

If your claim is accepted and a cash settlement is due, the funds will be settled via an EFT payment. Please provide your banking details below

LOSS DETAILS

Please attached quotes and repairer reports to repair or replace the above items

MOTOR ONLY

PREFERRED REPAIRER

DO YOU NEED TO ATTACH ANY EXTRA DOCUMENTS?

DECLARATION

Declaration: I/We certify that the information given in this form is truthful, accurate and complete. No information likely to affect this claim has been withheld. I/We understand that this claim may be refused if information is untrue, inaccurate or concealed. I/We consent to the collection, storage, use and disclosure of personal and sensitive information of all persons affected by this claim, with their approval.