Tools & Equipment Insurance Claim Form

Submit your
claim

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Insured Name*

Email*

Phone*

Policy number*

Insurance Product*

Claim details

Date of loss*

Time of loss or damage*

Loss or damage details*

Description of lost/stolen items (Make & Model, Serial no., Year item was purchased)*

Police report number*

Insurance history

Have you had any claims in the last 5 years? (YES / NO If Yes, provide details.)*

Has any Insurance Company refused to renew or cancelled/terminated a policy? Has any Insurance Company refused a claim? (YES / NO If Yes, provide details.)*

Have you been convicted of or had any fines or penalties imposed for any criminal offences in the last 10 years? (YES / NO If Yes, provide details.)*

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Form Title

GET A QUOTE

Discover the Elliott
Insurance difference

request a quote

Request A Quote

Tools & Equipment Insurance Claim Form

Submit your claim

Claim details

Insurance history

Discover the Elliott Insurance difference

Submit your
claim

Discover the Elliott
Insurance difference