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Step 1 of 14

7%
  • Business Claim Form

    The issue of this form does not constitute an admission of liability on the part of the insurer.

    Save and Continue: If you need to, you may save and continue completing this form at a later time. Click the 'save and continue later' link at the bottom of any page to do so.
    NOTE: Do NOT use the back button in your browser, use the PREVIOUS/NEXT buttons at the bottom of each page to go back and forward.

    Important: Please complete
    • PART A - Compulsory for all claims.
    • PART B - Relevant sections pertaining to your claim.
    • PART C - Compulsory for all claims.
  • PART A - Compulsory for all claims.

  • The Insured

  • Business Details

  • Contact Details
  • The Property

  • (eg. Mortgagee, Finance Co. leasee)
  • The Premises

    Where did the loss occur?

  • Ie, Factory, Warehouse, Office Block etc.
  • MM slash DD slash YYYY
  • Incident Details

  • MM slash DD slash YYYY
  • :
  • :
  • Give name and address of person responsible.
  • Details of Previous Loss Or Damage

  • TypeDate (dd/mm/yyyy)Amount ($) 
  • InsurerDate (dd/mm/yyyy)Amount ($) 
  • PART B - Complete relevant sections pertaining to your claim.

    If any of the following sections are not relevant, you may skip and continue.

    Click on NEXT below to continue.
  • Breakage of Glass

  • Accepted file types: pdf, png, jpg, Max. file size: 64 MB.
  • Storm and Water Damage

  • Theft or Burglary

  • 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.
    Drop files here or
    Accepted file types: pdf, jpg, png, Max. file size: 4 MB, Max. files: 5.
    • Security Details

      Any loss involving malicious damage, lost or stolen property must be notified to the police
    • Check all that apply.
    • Accepted file types: jpg, png, pdf, Max. file size: 4 MB.
    • Police Details

    • MM slash DD slash YYYY
    • Accepted file types: pdf, jpg, png, Max. file size: 16 MB.
    • PART C - Compulsory completion for all claims.

    • Details of Claims

      Please note both sections below maximum 15 items. If you need to claim more, please attach a list and show total amounts only below.
    • Max. file size: 64 MB.

    • ParticularsName of RepairerAmount Claimed ($) 



    • Description of Property (including serial number)Where PurchasedWhen Purchased (dd/mm/yy)Value at Time of Loss ($)Replacement Value ($) 
    • Please combine and attach all quotes as a single file here.
      Accepted file types: pdf, jpg, png, Max. file size: 8 MB.
    • Declaration and Authorisation

      The information and answers given above are true and complete in every detail. I understand the claim may be refused or reduced if information is withheld.
    • Electronic signature for the declaration above.
    • MM slash DD slash YYYY
    • Electronic signature for the declaration above.
    • MM slash DD slash YYYY
    • Note: Before submitting this form, please check that it has been fully completed as any omissions may delay your claim.
    • Please answer Yes here, to be able to submit your claim.
    • This field is for validation purposes and should be left unchanged.

    Contact

    Tel: (03) 9879 7699
    Fax: (03) 9879 7155
    Email: insurance@augib.com.au

    Important Information

    AFSL 227 200
    ABN 90 007 367 535
    Privacy Policy

    Links

    NIBA
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    AIG Travel Insurance

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