Vision Claims - BJS Insurance Group

Winbeat client code*

Insured Name*

Name of best contact person(s)*

Email address of best contact person*

Phone Number(s) of best contact person*

Policy Number*

Address of the damaged property*

Date and Time the loss occurred*

Type of claim - Choose all that apply*

Please provide a detailed description of the loss/damage that occurred*

Were the Police notified?*

Please tick all that apply

Upload claim documentation here

Drop files here or

Max. file size: 30 MB.

Max file size: 20MB

Is the Insured registered for GST*

If yes, please advise the Insured's ABN*

Does the Insured claim 100% ITC*

Please specify the ITC percentage % for the client if not claiming 100%*

Excess to apply (if known)*

Name of BJS Gippsland team member who lodged claim

Comments

This field is for validation purposes and should be left unchanged.

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