Claims Contact Form

For any claims queries, please fill out the form below.

Thank you for taking the time to contact us about your claim

Thank you for your query. Someone will be in touch with you shortly.

Apologies, we are currently unable to handle your request. Please try again.

Warning - The E-Mail Address configured for this form is either unverified or invalid. Please verify the E-Mail Address and try again later.

A verification E-Mail was sent to the following E-Mail addresses:

{Email}

Kindly check the corresponding inbox for a verification E-Mail and verify it.

Warning - Please add an email field in the form to proceed without any errors

First Name

Error Mandatory field

Last Name

Error Mandatory field

Error Invalid

Error Mandatory field

Email confirmation

Error Invalid

Error Mandatory field

Error The email addresses are not the same

Phone

Error Mandatory field

Please enter a valid phone number.

Please provide all the relevant policy details and a detailed description of your claim so that we can direct you to the right person.

Error Mandatory field

Please be sure to include your policy number.

Warning! Your mobileNumber field is not set up with the right component. Please use Textfield component with phone number validation, in order to avoid any errors when transporting data to Adobe Campaign

Enter the text below. 60 seconds remaining. Can't read the text?

Text in the box above

Error Mandatory field

We've encountered an error. Please enter your details again.

Sorry, that does not match the text in the box. Please try again.

This form has over 75 fields, which is the maximum allowed number. Form submissions will fail if this page is published.

Warning - The technical field name "{0}" is duplicated in more than one location. This will cause information loss when delivering the form submission. Please remove the duplicated field or rename its field name.

Warning! Please upload a file with the correct file type to proceed.

Emergency Assistance
+64 9 486 6868

Emergency Assistance is available 24 hours, 7 days a week.

Contact Us
0800 800 048

Our hours are Monday to Friday 8.30am - 5.00pm

Claims Contact Form

For any claims queries, please fill out the form below.

Thank you for taking the time to contact us about your claim

Please be sure to include your policy number.

Emergency Assistance +64 9 486 6868

Contact Us 0800 800 048

Follow us for updates

Emergency Assistance
+64 9 486 6868

Contact Us
0800 800 048