Car insurance claim

You are about to submit this claim form with the product issuer, QBE Insurance. Once you submit this form, an ANZ Claims specialist will contact you within 2 business days.

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Policy details
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Are you the policy holder?
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Policy holder's details
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Preferred contact method
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Incident details
Where did the incident occur?
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Incident description
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Is the car drivable?
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Does the car require a tow?
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Have you obtained any quotes to repair the damage?
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Car details
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Police report details
Have you reported the incident to the police?
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Third party
Was there a third party involved?
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Witness details
Were there any witnesses?
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Add another witness?
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Add another witness?
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Further driver information
In the last 5 years have you or any of the drivers of your vehicle ...
Had an accident, car stolen or burnt (even if not reported or not claimed for from an insurer)?
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Had your insurance refused, declined or cancelled by an insurer or special conditions imposed?
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Had a driver or motorcycle licence cancelled, suspended or endorsed?
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Been convicted of or charged with drug use, driving under the influence or exceeding prescribed concentration of alcohol?
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Had any driving offences or issued any speeding or traffic infringements?
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Been convicted of or charged with fraud, arson, theft or criminal act?
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Suffered from any physical or mental disability (excluding eyesight corrected by lenses)?
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Been declared bankrupt, owned or own a business which has been placed into liquidation or had a receiver or administrator appointed?
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