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Request A Claim

To notify us of any claims you have please complete the following form.

As soon as we receive the request we'll forward the appropriate claim form to you.

Claims may also be directed to: PO Box Q404, QVB Post Office, NSW 1230

Name
Address
e-mail
Phone (Home)
Phone (Work)
Fax
Policy Number
Date of Claim
Claim Details

Note:
The insurer/agent advises you that the issuing of a claim form is not, in itself, an admission of liability.











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