Thank you for providing us with notification of your claim. Please read the following details
before submitting this form.
1) For claims involving loss/damage to your own property the appropriate authorities, i.e.
Fire Brigade/Police, should be notified and every reasonable effort made to prevent further
loss/damage. Damaged property, if any, should not be disposed of without permission of the
Insurer or Assessor.
2) An assessor could be appointed and you will be advised if this action is taken.
• Keep in contact with the assessor so the report can be provided to Insurers on time.
• If there is any matter not receiving prompt attention you should call us immediately.
3) Please keep all supporting documentation for your claim for presentation to the Insurer or
Assessor, such as original invoices, receipts, owners manual, photos, etc. Quotes from
retailers or trade suppliers to replace/repair, itemising the precise nature of their quotation,
eg size, type, model, age, hours and cost of labour, cost of parts.
4) Where personal injury/property damage to third parties is involved, offer assistance but
DO NOT ADMIT LIABILITY. Advise the party involved to give written details of their claim
against you for passing on to your Insurer.
5) If your vehicle can be safely driven, a quotation for its repair should be returned with this
claimed form or provided by other means as soon as possible.
6) Repairs must not be authorised without Insurer’s approval.
7) Licence / permit of the driver (or a photocopy of both sides) should accompany this form
(enlarged if possible).
8) If anyone holds you responsible for damage to their vehicle or property, insist their claim
be in writing and include two quotations for repairs.
9) Insurers / Assessor may suggest a guaranteed repairer supply a quote if needed.

Privacy
The Privacy Act 1988 requires us to tell you that we as broker and the insurer collect your personal and sensitive information in order to calculate your loss and entitlements, determine the insurer's liability, compile data and handle claims. When handling claims we and the insurer 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. Where you give us information about other persons you must have their consent to this and provide it on their behalf. If not, you must tell us. You have the right to seek access to your personal information and to correct it at any time. Please contact us to advise if any changes are required.

Dispute Resolution
Disputes are not an everyday occurrence. However 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 that process, we will advise you how to contact the insurance industry's external independent complaints scheme (subject to eligibility).