Make a Claim claims If you are human, leave this field blank. Type of Policy Insurance type: Strata Insurance Machinery Breakdown Landlords Contents The Insured Name: Insert name of Strata Plan or Insured name if Landlords Contents. Strata Plan Number: Address of the Insured property: State: NSW QLD VIC WA ACT NT TAS SA Post Code: Contact Email for Strata Manager: GST Declaration Is the Insured registered for GST? Yes No If yes, what percentage is the Insured entitled to claim Input Tax Credits? ABN (11 digits): The Insurer Policy Number: Company: Excess: Is there any other insurance on the property? Yes No If Yes, please provide details of the insurer/s and policy numbers: What Happened Please explain how the loss or damage occurred. Where did the incident occur? Please provide the unit number or the location pn the common property. Date of Loss: Please advise who discovered the damage or loss. What date was the damage or loss discovered? Did any Person/s cause the damage? (whether intentional or not) Did another person cause the damage? Yes No - skip to next section If Yes, please provide the following. Unit Owner Tenant Other Explain Other: Please Complete: Title: Name: Address: Contact Number/s Business Hours: After Hours: Mobile: If damage caused by impact please provide: Description of vehicle (year, make and model) Registration Number of Vehicle: Vehicle Owner's Name & Contact Details: Police Report Police must be notified when property is lost, stolen or maliciously damaged - please ensure that notification is made prior to the claim being lodged. Police Station: Officer's Name: Date Reported: Crime Report Number: Contact Details Should an Assessment be Necessary Please provide the following information of a person who can provide access to the property for inspection purposes. Title: Name: Address: Contact Number/s: Business Hours: After Hours: Mobile: What is being claimed? Description of damaged property being claimed. If the claim is for theft, please advise the date of purchase, where purchased and original purchase price. Have you obtained quotations to repair or replace the damaged items? Yes - Refer to Supporting Documents Section No Please provide any additional information relevant to the claim. e.g. other contacts or repair information: Name: Position: (i.e member of Body Corporate, Unit Owner, Body Corporate Manager, Building Manager, etc) Email Address: Supporting Documentation Please attach any supporting documentation: Drop a file here or click to upload Choose File Maximum upload size: 52.43MB Additional Information - please complete the following: Name of person completing this form Relationship to Strata Plan Email address: Contact phone number: DECLARATION By submission of this claim form I declare that to the best of my knowledge and belief the information in this form is true and correct and I have not withheld any relevant information. I consent to BCB using the personal information I have provided on this form for purposes of processing my claim and in accordance with BCB's Privacy Policy. Where I have completed this form as a representative of another person, I confirm that person has authorised me to disclose their personal information included on this form and for that information to be used for purposes of processing their claim and in accordance with BCB's Privacy Policy. I understand that if I choose not to provide the required details my claim may not be able to be processed. I agree Yes No Date reCAPTCHA Website/URL
