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  • General details
  • Claim details
  • Declaration
Please complete the details below.
Claim Type
Home Contents Personal Effects in Transit

The supply or acceptance of this form is not an admission of liability on the part of Allianz Marine & Transit Underwriting Agency.

To assist us to quickly process your claim please include (where applicable) the following documents:

  • Copy of consignment note/shipping documentation/delivery note including terms and conditions on reverse
  • Copy of letter of demand against your removalist or other third party
  • Quotation for cost of repairs
  • Pictures of the damage
Insured details
Name of insured*
Policy number*
Contact person*
Postal address
Suburb
State
Phone number*
Email address
Are you registered for GST?*
What is your ABN*
Are you entitled to claim an input tax credit for repair or replacement of the items that have been lost or damaged?*
Are you claiming less than 100%?*
Please specify percentage*
%

Should a survey be required, our appointed surveyor will contact the person shown above, unless you advise an alternative contact.

Settlement details
Direct debit settlement payment

Where applicable AM&T will settle directly into your bank account once the liability for this claim is agreed.
Please provide your banking details.

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Where applicable Allianz Marine & transit will settle directly into your bank account once the liability for this claim is agreed.
Please provide your banking details.

Account name
Bank
BSB
Account number
Cheque settlement payment