Motor Vehicle Accident - Claims Helper & Claim Form

Had a motor vehicle accident? We’re here to help.

ProRisk and Armada Underwriting has appointed Quartz Claims Pty Ltd to manage motor vehicle claims on our behalf.

Most customers lodge their claim by phone. This form can help you gather the information we’ll ask for, or you can complete it if you’re unable to call.

Call or email to lodge your claim:

☎ 1300 001 427
✉ cmfclaims@prorisk.com.au

Our claims team can help with:

Immediate assistance
Towing and repairs
Next steps and timeframes

SECTION 1 - WHAT TO DO NOW

Step 1: Make sure everyone is safe

Move to a safe location if possible.
Call 000 if anyone is injured.

Step 2: Exchange details

Exchange names, contact details, and vehicle information with the other party.
Do not admit fault or discuss responsibility at the scene.

Step 3: Gather helpful information

When you contact us, it helps to have:

Where and when the accident happened
What occurred
Details of the vehicles and drivers involved
Any witnesses or police details (if applicable)

You can call us now, or use this form to note these details before or during the call.

SECTION 2 – WHAT HAPPENS NEXT

Once your claim is lodged, we will:

Confirm cover and assess the incident
Discuss repairs, towing, or next steps
Keep you informed as your claim progresses

SECTION 3 - YOUR DETAILS

Your Full Name: *

Email Address: *

Contact Number: *

License No:

Make *

Model *

Year *

Registration Number *

State: *

SECTION 4 - INCIDENT DETAILS

Date of Incident *

Location of Incident: *

Details of the Incident: *

Any witnesses? *

YesNo

Name

Phone

Name

Phone

SECTION 5 - POLICE / REPORTING DETAILS

Was the incident reported to police? *

YesNo

Police Report Number

Officer Name / Station

Police Event Number

Police Constable in Attendance

Police Station Reported To

Any other details we should know?

SECTION 6 - OTHER PARTY'S DETAILS

Driver's Name: *

License No:

Address: *

Phone Number: *

Registration Number *

Insurance Company *

SECTION 7 - SUPPORTING DOCUMENTS CHECKLIST

Upload Supporting Documents

Browse

Upload all supporting documents here (photos, reports, receipts, etc.).

SECTION 8 - PRIVACY & DECLARATION

Privacy Notice

We collect your personal information to assess and manage your claim. Your information may be shared with insurers, repairers, assessors, and service providers as required. Our privacy policy is available here.

Declaration

I declare that the information provided in this claim form is true and correct. I understand that providing false or misleading information may result in denial of my claim.

Declaration *

Signature *

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Your Name *

Date *

Please complete the verification below. *

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