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We just need some more information...

Please provide the following

After your claim is submitted…

  • Please allow 24 hours for your claim number to be generated.
  • Once generated, you will receive an email advising you of your claim number and the next steps relating to your claim.
  • Any information received to support your claim will be reviewed within 10 business days and you will be kept updated with the progress of your claim every 20 business days.

Alternatively, if you require immediate assistance call 13 2423.


  • Required fields

Personal details

Is your vehicle registered for GST?

Vehicle details

Registration expiry
Is your vehicle financed?
Does your vehicle have any modifications or accessories?

Incident details

Tell us the date of the incident
Was your vehicle being driven at the time of the incident?

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Are you able to drive your vehicle?
Was it towed?
Does it need to be towed?

Driver details

If the car was being driven at the time of the incident, who was driving?

If the driver is not listed on the policy, add their details below.

Did the driver consume any drugs or alcohol prior to the incident?

Where a third party was involved, please add their details below, if known.

A third party is an individual or entity that is involved in an event, but not one of the insured policyholders

Criminal, claim and incident history

You will be asked some criminal, claim and incident history questions now.

In respect to this or any other type of insurance held by any of the Insureds or drivers, has any insurer in the last five years refused to pay or denied a claim?
  • Refused to offer cover or invite renewal
  • Cancelled or avoided cover
  • Imposed special conditions on a policy
Please provide your response below
  • Fraud or dishonesty
  • Theft or robbery
  • Arson
  • Damage or threatened damage to property
  • Injury or threatened injury to another person
  • Drugs
  • Stolen goods
Please provide your response below
  • Lost their licence or had restrictions applied, other than for a fine default
  • Had any accident or incidents involving loss or damage to a motor vehicle
Please provide your response below

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Before you submit your claim, can you confirm that the information you've provided is honest and accurate?
  • the information you have provided is accurate, complete and not misleading
  • you have read and understood Hollard's and CBA's Privacy Notices1
  • if you are providing sensitive personal information (e.g. criminal history or health information) in this form, you consent to the collection, use and disclosure of that information for the purpose of administering your claim
  • if you are providing the personal information of others in this form, you confirm that you are authorised to do so on their behalf