Claim Form

Your Vehicle

Driver Details

Offending Vehicle Details

To process your Not At Fault Claim, we require the Offending Vehicle's Registration Number as a minimum.

If you have any other information of the At Fault Party, please provide it in the following fields to help support your claim.

Required fields are marked with *

Owner Details

Driver Details

Accident Details

Witness Details

What You Should Do

1. Before you sign this form contact us if you have any questions;

2. Complete the details on this form fully and truthfully. Provide as much information as possible;

3. Sign and return the form to us. Our address is on the first page;

4. Be prepared to provide us with a copy of the vehicle registration certificate and any other information about the collision

5. If you are comprehensively insured, lodge a claim form with your insurer marked “Report Only”. This will protect your rights and will not affect your no claim bonus if a claim is not made;

6. Refer any communications from the offending party or their insurers to us. Do not communicate directly with these people.

What We Will Do

1. Ensure that your vehicle is assessed by qualified assessors. There is no need for you to obtain any further quotes;

2. Make a claim on the offending party or their insurers. Upon recovery of funds, we will pay the repairer directly for the repair cost;

3. All costs and charges will be paid by the offending party or their insurance company. The repairer will also contribute to these costs and charges.

Authority To Act

I / We instruct National Motor Claims to act on my / our behalf to recover the losses arising from the collision as set out on this form.

I / We authorise National Motor Claims to:

  • do all things necessary for the conduct of the recovery action including settling the claim provided that the settlement covers all the costs arising from the collision and I have no further liability to any person;
  • negotiate an agreeable cost of repairs directly with my referring repairer to enable a settlement to occur;
  • commence legal proceedings (following any necessary advice from National Motor Claims) provided that my referring repairer and National Motor Claims are responsible for all costs incurred;
  • pay your referring repairer and any other service providers (e.g. assessor, rental vehicle provider) directly for any expenses properly incurred

I / We have been made aware of section 60 of the GICOP.

ZERO FAULT, ZERO COST.

If you're not at fault, you don't need to pay a cent out of your own pocket.

* Ts & Cs apply.

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OR

Go to Claim Form

Your Not At Fault Claim Has Been Submitted!

Thank you for submitting your Not At Fault Claim with National Motor Claims.

One of our Claims Specialists will be in contact with you shortly.

A copy of your Not At Fault Claim Form has been sent to you via e-mail.

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