Start your claim

Complete the details below as fully and truthfully as you can. The more information you provide, the faster we can act on your behalf.

Section 1

Your Vehicle

Registration (Rego) *

Year

Make *

Model *

Is your vehicle insured? *

Was someone else driving your vehicle at the time? *

Is the vehicle registered under a business? *

Section 2

Owner Details

The registered owner of your vehicle.

First Name *

Last Name *

Street Address

Suburb

Postcode

State

Contact Number *

Email *

Owner Licence

Licence Number

Licence Expiry

Date of Birth

Section 3

Offending Vehicle

The vehicle at fault, as best you know it.

Registration (Rego)

Year

Make

Model

Do you know if their vehicle is insured? *

Do you have the offending owner's contact details? *

Was someone else driving their vehicle at the time? *

Section 4

The Accident

Date *

Time

Place *

Description of Accident *

Was the incident reported to Police? *

Do you have a witness? *

Section 5

Authority to Act

What you should do

Contact us before you submit this form if anything is unclear.
Complete every relevant field fully and truthfully, with as much detail as you can.
Be ready to provide a copy of your vehicle registration certificate, the driver’s licence, and any other information about the collision.
If you are comprehensively insured, lodge a claim with your own insurer marked “Report Only”. This protects your rights and will not affect your no-claim bonus unless a claim is actually made.
Refer any communication from the other party or their insurer to us. Please do not deal with them directly.

What we will do

Arrange for your vehicle to be assessed by qualified assessors.
Pursue your claim with the party at fault or their insurer, and keep you informed of its progress.
Deal with the insurers, repairers and other parties on your behalf so you are not chasing them yourself.

Authority

I authorise CAMS Cover to act on my behalf in recovering the losses arising from the collision described in this form, and to:

do what is reasonably necessary to conduct the recovery, including negotiating and settling the claim;
correspond and negotiate with the party at fault, their insurer, my insurer, repairers, assessors and other service providers on my behalf;
obtain and exchange information relevant to the claim with those parties;
arrange assessment and repair of my vehicle, and arrange a replacement hire vehicle where I am eligible for one.

I confirm the information I have provided is true and complete to the best of my knowledge. I understand I may withdraw this authority at any time by notifying CAMS Cover in writing.

I have read and accept the Authority to Act above. *

Signed (type your full name) *

Date *