Financial Services Guide
New Claims Report - Property:
Insured name :
***Client must agree that all information supplied to us is true and correct in every detail.***
If registered for GST, ABN no
Type of claim : Burglary, fusion, water damage, glass, storm etc
Date of loss:
Where did the loss or damage occur:
How did damage/loss occur?
Has damage been repaired? - Yes/No
If yes, has invoice been paid? - Yes/No
- Police report number :
How were premises entered?
If damage is result of fire.
Did fire brigade attend? - Yes/No
Type of appliance and age of unit : - Yes/No
***Full report from Electrical Contractor to be supplied.***
If swimming pool pump
, is the pool above ground? - Yes/No
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