CLAIM VALIDATION QUESTIONS

Please answer the following questions and attach your supporting documentation (as either a photo and/or document) where required.

Policy Number

First Name

Last Name

DOB

Pre-existing condition definition:

What's the current end date you've been signed off?

Please attach your medical certificate

Photo

Doc

Please provide a brief description of the circumstances surrounding your injury or illness

MAINTENANCE COSTS

Photo

Doc

PREPAID EXPENSES

Photo

Doc

RECURRING EXPENSES

Photo

Doc

DAMAGED ITEMS

Photo

Doc

MISCELLANEOUS EXPENSES

Photo

Doc

OVERSEAS EXPENSES

Photo

Doc

What is the total amount you are claiming for?

Name of Bank

Name of Account Holder

BSB

Account number

Phone

I acknowledge that I have answered all questions truthfully and the information provided is a true and accurate representation and no information has been witheld.

Your claim has been submitted succesfully. An email confirmation has been sent to your nominated email address!

LIFESTYLE PLUS PRODUCT RANGE

CLAIM VALIDATION QUESTIONS

Please answer the following questions and attach your supporting documentation (as either a photo and/or document) where required.

IMPORTANT INFORMATION

Complaints Resolution

Privacy Statement

Financial Hardship

Family and Domestic Violence

Customer Vulnerability

Transalation and Interpreting Service

Duty of Disclosure

Financial Service Guide (FSG)

Website Terms and Conditions

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