Home and Landlord Insurance Claim

Please provide details for payment of your claim in the event that the claim is deemed payable.

If no name is provided, settlement will be effected to the payee as provided for under the terms of the policy.

Please note:
1. The Police must be informed immediately if the property has been lost or maliciously damaged.
2. A copy of the Police Report / Statement must be attached.

Please note:
1. Property damaged, lost or stolen are to be described in detail.
2. Receipts showing date, price / cost, and place of purchase of the article / item set out below should
accompany this form.
3. The Insured must promptly take all possible steps to trace /recover the property lost.
4. If the claim is for damage, an estimate for repair should be submitted. If the property is not repairable, a
letter from repairers to that effect should be forwarded. (This may or may not be applicable depending
on the terms of your policy. Please read your policy to check the provisions for damaged insured
equipment.)
5. All salvage must be retained.
6. In the case of damaged property, a set of photographs depicting the damage is to be submitted to us.

Please specify details of other claim(s) not declared in Section E and F.

(e.g. If available please provide Police Report, Photos, Statements)

The Privacy Act 1988 requires us to tell you that your insurer will collect your personal and sensitive information in order to calculate your loss and entitlements, determine their liability, compile data and handle claims. When handling claims, they may have to disclose your personal and other information to third parties such as other insurers, reinsurers, loss adjusters, external claims data collectors, investigators and agents or other parties as required by law.

You have the rights to seek access to your personal information and to correct it at any time.

Disputes are not an everyday occurrence with any insurers. However all insurers provide an internal dispute resolution process should any dispute arise. Please feel free to ask for details.

If you are not satisfied with the outcome of this process, your insurer will advise you how to contact their external independent complaints scheme. (subject to eligibility).

I / We certify that the information given in this form is truthful, accurate and complete. No information likely affect this claim has been withheld.
I / We understand that this claim may be refused if information is untrue, inaccurate or concealed.
I / We acknowledge that I / we have read and understood the Privacy Act 1988 information referred to above and consent to the collection, storage, use and disclosure of personal and sensitive information of all persons affected by this claim, with their approval.
I / We acknowledge that if I / we do / do not agree to the collection of this personal and sensitive information then my insurer may be unable to process my / our claim