TRAVEL INSURANCE CLAIM FORM

CLAIM TYPE

Please note if you are claiming for various incidents then you will need to tick each relevant claim type and complete the sections accordingly.

CLAIMANT DETAILS

PLEASE READ THE CLAIM FORM CAREFULLY.

- The issue of this claim form does not constitute an admission of liability
- Omission of relevant information may delay your claim

INSURED DETAILS
phone
email
HOLIDAY/TRIP DETAILS
DESCRIPTION OF CIRCUMSTANCES LEADING TO CLAIM

Describe fully the circumstances of the incident, which has led you to make the claim(s):
NOTE: It is vital that you explain as carefully as you can, the specific circumstances leading up to and following the incident.

BANK ACCOUNT DETAILS
DECLARATION

DO YOU REQUIRE ASSISTANCE?

If you have any questions or require any assistance please do not hesitate to call on 1300 62 62 68. Alternatively send an email to claims@noworriesinsuranceclaims.com.au and we will respond within 48 hours.