Homeowner’s Claim Form - Online Networksteadfast

NIG claims service

When a policy is taken up with Network Insurance Group, our dedicated claims team will help you to achieve the best outcome. We provide you with assistance from notification though to finalisation of the claim and we work closely with your insurer to deliver you the appropriate outcomes.

Tips to complete this online claim form:

Before you proceed further with this claim, please ensure you have:
Policy number, Date of loss, location of loss and loss description, preferred contact person.
If you have the above information this form should take less than 5 min to complete.

In an event of a loss:

Let us know if the loss is urgent which requires make safe/temporary repairs to be carried out – this will allow NIG claims team to request insurer to appoint trades immediately.
If you have repair quote or invoice, please attach them for the insurer to assess.
If you have photos to damage, please attach them so that we can accurately assess your claim.
Take reasonable steps to minimise your loss.
Photograph the damage.

Policy Information
Policy Number*
Name of Policy Holder or Company*
Primary Contact Full Name*
Loss Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Contact Number*
Date of Loss
DD slash MM slash YYYY
Cause of Loss*
Have the police been notified?
- Yes
- No
Police Station
Date
MM slash DD slash YYYY
Police Report Number
Please provide Third Party Details
Name
Rego
Contact Details
Mobile No*
Are you registered for GST?
- Yes
- No
ABN
Are you entitled to claim an input tax credit (ITC) from the loss suffered?
- Yes
- No
Have you claimed or intend to claim the input tax credit on the GST component of the premium applicable to the policy?
- Yes
- No
Specify percentage claimed
Loss Information
Do you require immediate, professional make safe?
Loss Description:
Any other relevant information
Declaration
Signature*
Upload Image
Max. file size: 64 MB.
Date*
DD slash MM slash YYYY
Consent*
I/We do hereby declare that the foregoing answers are true and correct. I agree that if I have made or shall make any false or untrue statement, suppression or concealment, my right to claim could be forfeited.
Name
This field is for validation purposes and should be left unchanged.

Policy Information

Loss Information

Declaration