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Make a Casualty and Specialty claim

Call 132 687 for all claims

Western Australia

 

Claims forms for email, postal or fax lodgements

Workers' Compensation Claim Form 181 KB, pdf When an injured worker sustains an injury, the Workers Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the First Medical Certificate to the Employer so that they can then lodge it with the Insurer.
Employer's Report of Injury Claim Form 263 KB, pdf The Employer’s Report Form is to be completed by the Employer once an injured worker lodges a claim for Workers compensation. The claim form assists the Insurer in the decision making process.
Injury on the Journey Claim Form WA 165 KB, pdf The Form is required to be completed when a worker is involved in a Motor Vehicle Accident whilst they are in their employment.
Recurrence of Disability Claim Form 226 KB, pdf The Recurrence of Disability Claim Form needs to be completed by the injured worker if they sustain a recurrence of the original injury.
Workplace Fatality Claim Form 295 KB, pdf When a worker has died as a result of a work related injury a claim for compensation can be made by the worker’s dependants under the Workers Compensation and Injury Act 1981. The dependant is required to complete the Workplace Fatality Claim Form and provide this to the Employer to lodge with the Insurer.
WorkCover return to work program template 107 KB, docx The Return to Work Program Template is required to be completed by the Employer when an injured worker is back at work on light/restricted duties. The program is signed by both the Employer and the injured worker.
Work Restrictions Form 145 KB, pdf This Form is utilised to determine what the injured worker’s capabilities are to be able to perform their normal duties.
Request for wages reimbursement 396 KB, pdf The Wages Reimbursement Form is to be completed by the Employer so that the Insurer can reimburse the Employer for the time off work that an injured worker has as a result of the injury.

Email: wcclaims.wa@zurich.com.au

 Post: Zurich Financial Services, PO Box 442, West Perth WA 6872

 Fax: 08 9261 1390

Tasmania

 

Claim forms for email, postal or fax lodgement

Tasmanian Early Injury Notification Form 961 KB, pdf This form is required to be completed and forwarded to Zurich Australian Insurance Limited within three (3) days of becoming aware of a work injury that may result in a claim or incapacity to the worker.
Tasmanian Worker’s Claim for Compensation 205 KB, pdf When an injured worker sustains an injury, the Workers Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the First Medical Certificate to the Employer so that they can then lodge it with the Insurer.
Request for Wage Reimbursement 476 KB, pdf The Wages Reimbursement Form is to be completed by the Employer so that the Insurer can reimburse the Employer for the time off work that an injured worker has as a result of the injury.

Email: wcclaims.tas@zurich.com.au

 Post: Zurich Financial Services, GPO Box 801 Canberra ACT 2601

 Fax: 1800 074 778

Call 02 6247 3766

Australian Capital Territory

 

Claim forms for email, postal or fax lodgement

Early Injury Notification Form 97 KB, pdf The employer uses this form to provide information about an injury to Zurich within 48 hours of an injury occurring.
ACT - Employees Compensation Claim Form 511 KB, pdf When an injured worker sustains an injury, the Employees’ Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the Certificate of Capacity to the Employer so that they can then lodge it with the Insurer.
Injury on the journey claim form - ACT 569 KB, pdf The Form is required to be completed when a worker is involved in a Motor Vehicle Accident whilst they are in their employment.

Email: wcclaims.act@zurich.com.au

 Post: Zurich Financial Services, GPO Box 801 Canberra ACT 2601

 Fax: 1800 074 778

Call 02 6247 3766

Claim forms for email or postal lodgement

Personal Accident / Sickness Insurance Claim form 552 KB, pdf
Group Journey Injury Insurance Claim form 698 KB, pdf
Golf - Personal Accident Claim form 61 KB, pdf

Email: ah.claims@zurich.com.au

 Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059

 Fax: 02 9995 4093

Call 132 687

Claims forms for email, postal or fax lodgement

Liability Claim form 984 KB, pdf

Liability - Property Damage Claims Email: pdl.claims@zurich.com.au

Liability - Bodily Injury Claims Email: liability.claims@zurich.com.au

 Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059

 Fax: 1800 284 929

Call 132 687

Emergency Travel Assist: +61 2 9995 2800

Claim forms for email or postal lodgement

Business Travel Insurance Claim form 565 KB, pdf
Corporate Travel Insurance Claim Form 709 KB, pdf

Email: ah.claims@zurich.com.au

 Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059

Call 132 687

Professional Indemnity, Directors and Officers, Employment Practices, Management Liability

Financial Lines Claims can be made under any products such as Directors and Officers Liability, Councillors and Officers Liability, Professional Indemnity, Crime and Employment Practices Liability. The range of claims that can occur is very broad. To assist you in making a claim under a Financial Lines Product we have developed a range of Claim Forms and Guidelines which can assist.

Claim forms for email or postal lodgement

Professional Indemnity Insurance Claim Form 908 KB, pdf
Directors and Officers Liability Insurance Claim Form 887 KB, pdf
Employment Practices Liability Claim Form 847 KB, pdf

Email: fl.claims@zurich.com.au

 Post: The Claims Manager, Financial Lines Claims, PO Box 677, North Sydney NSW 2059

Call 132 687

Guidelines
Directors and Officers' Liability Claims Reporting Guidelines 571 KB, pdf
Professional Indemnity Claims Reporting Guidelines 590 KB, pdf
Councillors and Officers Liability Claims Reporting Guidelines 609 KB, pdf
Employment Practices Liability Claims Reporting Guidelines 586 KB, pdf
Commercial Crime Insurance Reporting Guidelines 593 KB, pdf

Claim forms for email, postal or fax lodgement

Golf - Legal Liability Claim form 599 KB, pdf
Golf - Sporting Equipment Claim form 692 KB, pdf

Liability - Property Damage Only Email: pdl.claims@zurich.com.au

Liability Email: liability.claims@zurich.com.au

 Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059

 Fax: 1800 284 929

Call 132 687

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When it comes to claims, Zurich delivers

Zurich’s customer claims team is among the best in the business with credentials to show for it, including:

  • An average 4.5 stars out of 5 claims rating (claimscomparison.com)
  • Australian General Insurer Claims Team of the Year (2019 Insurance Business Awards)

More on Zurich claims

General Insurance Factsheet 146 KB, pdf

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