CoverWise Support

Claims Form

Section 1 - Your Details

Name/Entity Name(Required)

Phone(Required)

Email(Required)

Policy Number(Required)

Section 2 - Policy Details

Agent Name(Required)

Agent Phone(Required)

Agent Email(Required)

Does the entity above have an ABN(Required)

Yes

ABN #

Is the Landlord registered for GST?(Required)

Yes

Section 3 - Tenancy Information

Type of Lease(Required)

Long Term (3 Months or more)

Short Term/Holiday (less than 3 months)

Tenants Name On Lease(Required)

Tenant Phone(Required)

Lease Start Date(Required)

Lease End Date(Required)

Section 4 - Point of Contact

Best point of contact for access to the property?(Required)

Best contact for updates and communication of the claims?(Required)

Section 5 - Loss Details

Date of Loss(Required)

Is this property of a Strata/Body Corp/Community Title(Required)

Yes

Strata Pan Number/Body Corp Number/community Scheme number(Required)

Insured Property Address(Required)

Did the tenant cause the damage?(Required)

Yes

Please select the type of loss that applies to this claim(Required)

Police report number

Description of Loss(Required)

Items Being Claimed(Required)

Item

Month/Year of Purchase

Original Purchase Amount

Quote to Replace

Section 6 - Rent Default & Loss of Rent Claims

Has tenant given notice?(Required)

Yes

Date of notice given

Have notices been given by the agent to the tenant to vacate?(Required)

Yes

Date of notice given

Weekly Rental Amount(Required)

Date Rent Paid To(Required)

Tribunal Date

Tribunal Outcome

Date Relet

Rental Amount Claimed(Required)

Please include the following when submitting your claim:
• Copy of Tenant Rental Ledger
• Copy of Lease Agreement of Defaulting Tenant
• Copy of New Tenancy Lease Agreement (if secured)
• Executed Warrant (if applicable)
• Copies of Invoices & Quotes for all Bond Expenses
• Copies of All Notices Issued

Upload Files

Drop files here or

Max. file size: 256 MB, Max. files: 10.

Section 7 - Electronic Funds Transfer Details

Name of Financial Institution(Required)

Account Name(Required)

BSB(Required)

Account Number(Required)

The information provided by CoverWise REI Pty Limited on this website is for general information purposes only, and it is not a substitute for professional advice. You should always consider the PDS/Policy wording before making a decision. Coverage may differ based on specific clauses in individual policies.

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CoverWise REI Pty Limited | ABN: 61 630 707 792

Authorised Representative No: 1274661 of PSC Connect Pty Limited

ABN: 23 141 574 914 AFS License No: 344648

CoverWise REI Pty Ltd endorses the Insurance Brokers Code of Practice. To obtain a copy of the code, click here