11111
Regd Prop: Central Brokerage Services Pty Ltd (ABN: 19 008 801 241)
52 Melville Parade, South Perth WA 6151 PO Box 408, South Perth WA 6951 Ph: (08) 93688-999 Fx: (08) 93675-335 Web:
www.centralins.com.au
AFSL: 241187
STORE THIS DOCUMENT IN VEHICLE INFORMATION TO OBTAIN IN THE EVENT OF A MOTOR VEHICLE ACCIDENT Insured MV claim checklist 0407
Road Accidents – If property damage/loss is more than $1,000 it must be reported to the police with a minimum of delay.
All Bodily injury claims must be reported to the I.C.WA (Insurance Commission of WA) immediately. Phone (08) 9264-3333.
Always get names and address of “independent” witness (someone other than those you know). Even if the other party acknowledges liability they may change their opinion on a claim form.
MINIMISATION OF LOSS: In the event of circumstances which may give rise to a claim and/or upon the happening of a claim the insured has an obligation to do all things necessary and reasonably available to reduce the amount of loss or further loss and/or Liability.
"What a reasonable person would reasonably do or be expected to do under reasonable circumstances".
Accessories not covered unless listed (some insurers include a special sub limit, similar to car policies).
Accessories must form part of a vessel ie., not personal accessories (same as car policies).
Drivers The insurer will require a photocopy of the current driver's licence of the driver in charge of the vehicle at the time of the accident.
Accident location:………………………………………………………………………………………………….. Include nearest cross road Date: .…../…..../………. Time: …………..am/pm Vehicle details: Year Make -------
Model
weather conditions:……………………………………. Registration
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Driver name:……………………………………………………………………………………….. DOB:……………… Residential Address………………………………………………………………………………………………………… Best contact number: work:……………………………………… mobile:…………………………………….
If there is a 3rd party vehicle involved complete details on the reverse
DON'T ADMIT LIABILITY: Subject to the provisions of the Insurance Contracts Act 1984, the insured or any person making a claim must not make any admission of liability or payment or promise or offer of payment in connection with any claim without written consent from the insurer. Likewise you must not accept any offer to settle if you intend involving your insurer.
nb: this a checklist to collate initiate details at the scene of an accident (it is not a claim form) As soon as reasonable practicable contact us, we will notify the insurer and initiate the formal claim process. o detailed claim procedure is listed on our website under “client manual” Page 1 of 2 The issue of this form does not constitute an admission of liability on the part of the insurer
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nb: this a checklist to collate initiate details at the scene of an accident (it is not a claim form) ďƒź As soon as reasonable practicable contact us, we will notify the insurer and initiate the formal claim process. o detailed claim procedure is listed on our website under “client manualâ€? Page 2 of 2 The issue of this form does not constitute an admission of liability on the part of the insurer