Claim Assistance Eligibility Form
Please fill in your details below.
Once the form is complete, we will take you to our calendar where you can book a call with one of our claim consultants.
Your contact details
First Name
*
Last Name
*
Phone
*
Email
*
Are you a property owner?
*
Select options
Yes
No
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I’ve owned this property for
*
Select options
0-2 years
3-5 years
5 or more years
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What postcode is your property located in?
*
Which Insurance company are you with?
*
How much is your excess (we can cover the cost of this for you… ask us how)?
*
Select options
$0 - $500
$501 - $1500
$1,500 or greater
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Have you noticed any storm or wind damage over the last 3 years?
*
Select options
Yes
No
Not sure
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Does your property have any leaks inside, mould or water stains on the walls?
*
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Yes
No
Not sure
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What material is your roof?
*
Select options
Asbestos
Metal
Tile
Other
Not sure
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How old is your roof?
*
Select options
Less than 5 years
5-10 years
Over 10 years
Not Sure
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Have you had your roof inspected in the past 5 years
*
Select options
Yes
No
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