Insurance Claim Form

To help process your claim in a timely manner please provide the following information.

Date: Required

Request for: Required

Lot number: Required

Person making the claim: Required

Email address: Required

Telephone number Required

What is damaged / being claimed? Required

Amount being claimed:

How did the damage occur? Required

Date of loss / damage: Required

Who discovered the loss / damage? Required

Do you know who caused the damage / loss? Required

Yes

Unknown

If known, provide details of the person below.

Details of person:

If a vehicle was involved, provide the vehicle registration and details.

Vehicle details:

Police must be notified when property is lost, stolen or maliciously damaged - ensure police are notified prior to lodging this claim.

Police station:

Officer's name:

Date reported:

Police report number:

Attach photos, quotes, invoices, police report and any other supporting documents:

Attach further documents below. If you have more than three (3) documents to attach, email further documents to info@stratainfluence.com.au.

Supporting documents

I / we confirm that we are entitled to make a claim against the Body Corporate Insurance Policy and that we will be responsible for any excess if, under the BCCM Act, I/We are responsible for the payment of the excess.

DECLARATION

Required

I / we hereby declare the answers to all the questions are true and correct and I/We have not concealed anything of which the underwriters should be aware.

STRATA INFLUENCE

To help process your claim in a timely manner please provide the following information.

DECLARATION

STRATA
INFLUENCE