Business Claim Form

(Fire, Burglary, Plate Glass, Other Property)

Please ensure your business is secured and if necessary you may authorise temporary emergency repairs up to $500 (if the claim is approved) to protect your business from further loss or damage.

To assist rapid processing of your claim :

• Report the loss to the Police (Theft or Malicious Damage) Obtain a quotation for the replacement or repair of the damage or loss
• Receipt(s) from the original purchase will also assist with the claim
• Download the claim form and complete it
• Fax all information to our office on (08) 9433 3411

*The claim form can be opened in Adobe Acrobat Reader (Click here to download and install this free program if it's not already on your system) You can complete the form in that application using the editable fields provided prior to printing it out if preferred. Type Xs into the check boxes as required. Only your signature and the date need to be completed in pen after printing out the form.

Business Insurance Claim Form (318 KB)