Travel Insurance Claims

You can lodge an online claim anytime – 24 hours, 7 days a week.

Type of travel insurance claim

Please select type of Travel Insurance Claim(Required)

Medical expenses

Lost / stolen luggage / personal effects

Delayed baggage

Additional forfeited costs

Hire car

Cancellation – loss of deposits

Insured Details

Policy Number

Insured Name(Required)

Insured's Address(Required)

Insured's Email(Required)

Insured's Phone Number(Required)

Are you registered for GST?(Required)

Yes

What is your Australian Business Number (ABN)?

Are you entitled to claim on input tax credit on this policy?(Required)

Yes

Input Tax Credit %

Travel Information

Name of person who the claim relates to?(Required)

Departure Date(Required)

Return Date(Required)

Departure City(Required)

Destination City(Required)

Departure Country(Required)

Destination Country(Required)

Reason for Travel(Required)

Business/work

Holiday

Combination

Other

Please give details of reason for travel(Required)

Loss Details

Date of the Incident(Required)

Time of the Incident(Required)

Hours

Minutes

AM/PM

Incident City / Address(Required)

Incident Country(Required)

Description of how the loss occurred(Required)

Medical Expenses

Was the Emergency Assistance Company contacted?(Required)

Yes

Please give details.(Required)

If an Illness, has the claimant suffered this complaint before?(Required)

Yes

Please give details.(Required)

Date of Expense(Required)

Medical and/or Hospital Expenses(Required)

Tick to add additional items

Date of Expense

Medical and/or Hospital Expenses

Amount Claimed (Please state currency)

Tick to add additional items

Date of Expense

Medical and/or Hospital Expenses

Amount Claimed (Please state currency)

Lost/Stolen/Damaged Luggage & Personal Effects Details

This section is to be completed ONLY where the event has occurred AFTER THE COMMENCEMENT of the Insured Travel.

Medical Receipts will be required to accompany this section.

We reserve the right to call for all details of medical history of the claimant, or the person whose accident, illness or death necessitates the curtailment of the journey.

All medical and hospital accounts incurred within Australia must first be submitted to Medicare for refund, and/or to your private health fund if applicable.

Was the incident reported to Police or any other authority?(Required)

Yes

Please provide report / Incident No(Required)

Were articles lost by the carrier?(Required)

Yes

Note: The Warsaw Convention & The Montreal Conventions imposes a liability upon the carrier and you should claim against them first.

Were all the missing articles your property?(Required)

Yes

Who is the owner?(Required)

Have you lodged a claim or complaint against any Carrier/Airline or other authority or against any individual responsible for the loss or damage to your property?(Required)

Yes

Please provide details and attach correspondence below:(Required)

Are you claiming for spectacles, dentures, or a hearing aid(Required)

Yes

Are these items claimable against your private health fund?(Required)

Yes

Name of Fund(Required)

Membership No.(Required)

Amount Paid by Health Insurer (include currency)(Required)

STATEMENT OF CLAIM

Give a full description of the article(s) lost or damaged and in addition a fully detailed description of the damage where applicable. Please attach relevant documentation to support your claim, e.g. receipts, photographs, manuals.

Full description of article/s and details of damage where applicable(Required)

Original Cost Price(Required)

Date and Place of Purchase(Required)

Has item been replaced(Required)

Yes

Amount Claimed(Required)

Currency(Required)

Tick to add additional items

Full description of article/s and details of damage where applicable

Original Cost Price

Date and Place of Purchase

Has item been replaced

Yes

Amount Claimed

Currency

Tick to add additional items

Full description of article/s and details of damage where applicable

Original Cost Price

Date and Place of Purchase

Has item been replaced

Yes

Amount Claimed

Currency

Delayed Baggage Details

Date of your arrival:(Required)

Time of your arrival:(Required)

Hours

Minutes

AM/PM

Date of luggage arrival:(Required)

Time of luggage arrival:(Required)

Hours

Minutes

AM/PM

Compensation paid by carrier:(Required)

Currency(Required)

Statement of Claim

Please attach relevant documentation to support your claim, e.g. receipts, photographs, manuals.

Full description of article(Required)

Original Cost Price(Required)

Date and Place of Purchase(Required)

Replacement Cost(Required)

Tick to add additional items

Full description of article

Original Cost Price

Date and place of purchase

Replacement Cost

Tick to add additional items

Full description of article

Original Cost Price

Date and place of purchase

Replacement Cost

Additional and/or Forfeited Expenses

This section is to be completed ONLY where the event has occurred AFTER THE COMMENCEMENT of the Insured.

Please supply original accounts or receipts for accommodation and transport costs.

For additional expenses, a MEDICAL CERTIFICATE from the doctor who treated you must be provided to support change of plans due to accident, illness or death.

Details of original plans for accommodation/transport and how were they changed:

Details of original plans for accommodation/transport and how were they changed:(Required)

Please ensure copies of original and amended itineraries are provided.

Description of Additional Transport / Accommodation Expenses or Forfeited Expenses(Required)

Date of Expenses(Required)

Amount Claimed (Please state currency)(Required)

Hire Car Expenses

Driver's Full Name(Required)

Type of Vehicle(Required)

Name of Vehicle Hire Company(Required)

Rental Vehicle Excess(Required)

Currency(Required)

Actual Repair Costs(Required)

Currency(Required)

Amount you are claiming(Required)

Currency(Required)

Cancellation/Loss of Deposits

A supporting document from the travel provider showing cancellation charges must be submitted with this form.

Date travel arrangements booked:(Required)

Date of Cancellation:(Required)

Reason for Cancellation:(Required)

Is cancellation due to accident, illness or death state of another person?(Required)

Yes

Full Name of Person(Required)

Relationship of Person to Claimant(Required)

IN THE EVENT OF DEATH, PLEASE ATTACH DEATH CERTIFICATE BELOW

Amount Paid(Required)

Currency(Required)

Amount Refunded(Required)

Currency(Required)

Amount Claiming(Required)

Currency(Required)

If no refund amount is noted, please state why (you must obtain all refunds possible).

Payment Details

If your claim is accepted, to ensure a prompt settlement, would you like the funds deposited into your Bank Account?(Required)

Yes

Bank Name(Required)

Account Name(Required)

BSB(Required)

Account Number(Required)

ATTACH RELATED DOCUMENTS/PHOTOS

Please attach original purchase dockets, invoices or receipts. If you provide as much proof about owning the items it will help us to process your claim quickly.

Attach Files (32mb maximum)

Drop files here or

Max. file size: 512 MB.

Insurance &
Risk Experts

Insurance & Risk Experts

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0240 818 789

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