Submit a Claim

Date*
Name*
Email*
Phone*
Address*
ABN (if applicable)
Type of Loss* ---HomeContentsFarmBusinessCarTruckMotorbikeCaravanPlantBoat
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) ---YesNo

Ownership Documentation (for building claims)

GST Registered? ---YesNo
ITC%
Road where incident occured? (for vehicle claims)
Vehicle Driveable? (for vehicle claims) ---YesNo
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) ---YesNo
Third Party Details (for vehicle claims)