Claims Form – Axis Underwriting

Your Details

Who are you?

Name *

Email *

Phone *

Relationship to Property *

Building/Strata Plan Details

What are the details of the Building/Strata Plan No.?

Address *

Address Line 1

City

State / Province / Region

Postal Code

Business Name / Strata Scheme No. *

Unit or Lot No. *

Policy Number *

Is the Strata Plan or Insured entity registered for GST? *

Tell us What Happened

Do you know when it happened?

Date / Time of Loss *

Date

Time

Tell us what happened, how it happened and what (specifically) was damaged? What (if any) action have you taken to minimise further loss of damage? Any other important or relevant information? (Third party details / Police Report No. / Witness details etc.)

Is the premises currently occupied? *

Have repairs been arranged? *

Do you hold any other insurances where a claim may be made? *

Additional Contacts

Is there anyone else we should contact in regards to this claim i.e. such as Strata Manager, Broker, building manager, tenant, managing agent etc

Name

Phone

Relationship to Property

Name

Phone

Relationship to Property

Name

Phone

Relationship to Property

Payment Information

If a payment is to be made, EFT is our preferred method; the account payee should be the Insured name listed on the policy.

Account Name *

Account Number *

BSB *

Supporting Documentation

Please include any supporting documentation for the incident such as photos, quotes and invoices etc.

Upload Documents

Click or drag files to this area to upload. You can upload up to 20 files.

Declaration *

By submitting this claim form to Axis, I/We declare that to the best of my/our knowledge the information being sent is true and correct and I have not withheld any relevant information.
I consent to Axis using the personal information I have provided on this form for purposes of processing my claim and in accordance with the Axis Privacy Policy.
I understand that if I do not provide the required information, my claim may not be processed or delayed until we receive the required information.

Alternately if you prefer to email your claim form along with any supporting information, please send it to claims@axisunderwriting.com.au

Axis Underwriting Services · ABN 51 090 508 142 · AFSL 236650

Axis Underwriting Services
ABN 51 090 508 142 · AFSL 236650

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Make your Claim

Your Details

Building/Strata Plan Details

Tell us What Happened

Additional Contacts

Payment Information

Supporting Documentation

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