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Submit a Claim

Please complete the following details and click Send. We will review your claim and contact you.

* Required Information

Date*
Name*
Email*
Phone*
Address*
ABN (if applicable)
Type of Loss*
Date of Loss*
Time of Loss*
Preferred Repairer
Fusion age of unit (for building claims)
Reported to Police? Report number (if applicable)
Proof of Ownership? (for building claims)

Ownership Documentation (for building claims)

GST Registered?
ITC%
Road where incident occured? (for vehicle claims)
Vehicle Driveable? (for vehicle claims)
Driver (for vehicle claims)
Date of Birth (for vehicle claims)
Rego (for vehicle claims)
Vehicle Description (for vehicle claims)
Were Alcohol or Drugs involved? (for vehicle claims)
Third Party Details (for vehicle claims)

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