Your claim 1Start2Your details3What happened4Loss details5Summary Get started Reference numberYou can find this in the top right-hand corner of documents for the policy you want to make a claim on and in emails from us. It is either called your 'customer reference' or your 'policy number'. Customer references are either 8 or 10 digits long, and may be followed by a policy reference. For example, 12345678 or 1234567890 with '/MTR001' after the customer reference number. If you have both (12345678/MTR001), please use them as shown, otherwise just using your customer reference number is fine. Policy numbers start with 'P' followed by 11 digits. For example, P12345678910. What are you claiming for?* Car Contents House What happened to your car?* Damaged while parked Stolen Accident while driving Other How was your car damaged?*Pick the best option, or if there isn't a match select 'Other'. Hit by another vehicle Broken into Vandalism Weather Fire Other What happened to your contents?* Damaged Stolen Lost Natural disaster Other How were your contents damaged?*Pick the best option, or if there isn't a match select 'Other'. Accidental damage Water Weather Vandalism Fire Other Where were they stolen from?*Choose the option that best fits. For 'My home' you don't need to own the home, this just means it's your usual living situation. My home A car Somewhere else What happened to your house?* Damaged Fire Broken glass Natural disaster Other How was your house damaged?*Pick the best option, or if there isn't a match select 'Other'. Burglary Vandalism Accidental damage Water Weather Other What caused the damage?*EarthquakeLandslideFloodTsunamiVolcanic activity For claims like yours we can help more quickly if you give us a call on 0800 379 372. Our team is available 8am-6pm Monday to Friday and 9am-5pm on Saturday and public holidays. We also have an after-hours helpline so you can talk to someone 24/7. If your claim isn't urgent you can continue with this form, our team will be in touch as soon as possible. If you’re claiming for more than ten items it can be quicker to give us a call on 0800 379 372. Our team is available 8am-6pm Monday to Friday and 9am-5pm on Saturday and public holidays. We also have an after-hours helpline so you can talk to someone 24/7. If your claim isn’t urgent you can continue with this form, our team will be in touch as soon as possible. We can help with urgent claims more quickly if you give us a call. If a lot of items were damaged, or you can’t currently live in your home, please phone 0800 379 372. Our team is available 8am-6pm Monday to Friday and 9am-5pm on Saturday and public holidays. We also have an after-hours helpline so you can talk to someone 24/7. If your claim isn’t urgent you can continue with this form, our team will be in touch as soon as possible. Your detailsName* Prefix TitleMrMrsMsMissDr First Last Date of birth (dd/mm/yyyy)* Email address*We'll send all important messages to this email address. Phone number* Additional phone number Postal address*Start typing the address and select the right match when it appears. If you can't find your address, try another format, e.g. Flat 2B/8 Howe Street, 2B/8 Howe Street, Flat 2B, 8 Howe Street. If a match still doesn't come up, select 'Can't find your address?'. What's the best way of contacting you?*If you have a preferred contact method we'll try get hold of you that way first. Phone Email Do you want updates on your claim by text message?*These are quick, free updates to let you know when something changes. You'll still receive full communication by phone or email. Yes No What happenedWas the car being driven?* Yes No Was another vehicle involved?* Yes No When did it happen?*It's OK if you don't know the exact time, just put in an estimate. Hour - When did it happen?*Hour000102030405060708091011121314151617181920212223Min - When did it happen?*Min001020304050Where did it happen?*Please be as specific as possible with the location. Include an address if you have one, or if it happened on the street outside a particular address.Has your car been found?* Yes No When did you last see your car?*We need a rough idea of when the car was stolen. It's OK if you don't know the exact time, just put in an estimate. Hour - When did you last see your car?*Hour000102030405060708091011121314151617181920212223Min - When did you last see your car?*Min001020304050When did you notice it was gone?*If you can't remember the exact time you discovered it had been stolen, an estimate is OK. Hour - When did you notice it was gone?*Hour000102030405060708091011121314151617181920212223Min - When did you notice it was gone?*Min001020304050When did you last see the item/s?*We need an idea of when you last saw the items. It's OK if you don't know the exact time, just put in an estimate. Hour - When did you last see the item/s?*Hour000102030405060708091011121314151617181920212223Min - When did you last see the item/s?*Min001020304050When did you notice they were missing?* Hour - When did you notice they were missing?*Hour000102030405060708091011121314151617181920212223Min - When did you notice they were missing?*Min001020304050Was it stolen from your home address?*Select yes if it was stolen from your property, or from the street right outside it. Yes No Where was it stolen from?*Did this happen at your home?*You don't need to own the home, this just means it's your usual living situation. Yes No Where did it happen?*Start typing the address and select the right match when it appears. If you can't find your address try another format e.g. Flat 2B/8 Howe Street, 2B/ 8 Howe Street, Flat 2B, 8 Howe Street. Description of the location.*Where happened input type* Address Description Was the car parked at your home address?*Select 'Yes' if your car was parked anywhere on the property, or on the street directly outside it. Yes No Where was it parked?*Please selectOn the streetDrivewayCarportGaragePublic/paid carparkOtherDescribe where it was parked.*Where do you think the item/s may have been lost?*If you're not sure put down the last place you remember seeing them Please be as specific as possible. For example if it happened at a mall put in the mall name and address.Tell us what happened.* Provide as full a description as possible, remember to include: what you were doing before/when the damage happened who first noticed the damage and how anything else that's relevant e.g. if someone witnessed the incident or left a note how, or how you think, the damage happened who first noticed it and how anything else that's relevant e.g. if you've taken any steps to reduce further damage. Tell us what happened.*Who was living in the house at the time?*Choose the option that best suits. If you were on holiday at the time and the house was empty pick 'It was empty'. Just me Me and my spouse/immediate family Me, and flatmates and boarders Tenants It was empty Other When was the last time someone was living in the house?*If you can't remember the exact date an estimate is fine. Describe who was living in the house.*Did the fire service attend?* Yes No What was the cause of the fire?*If you're unsure select 'Don't know' for now. We can update this later.Please selectDeliberately litElectrical faultAccidentalDon't knowWas the house locked and all windows closed?* Yes No Tell us a bit more about what wasn't locked or closed.*Was an alarm set?* Yes No There is no alarm Not sure Were any keys stolen?*This is any type of key so include car keys as well. Yes No Let us know what the keys are for and when you noticed they were gone.*Where were the items at the time of the theft?*For example at friends house, at work etc.Let us know if the items were secured.*For example were they in a locked building, in a locker etc. If they weren't secured just enter NoWere you the driver at the time of the accident?* Yes No Driver Name* Prefix TitleMr.Mrs.Ms.MissDr. First Last What type of driver licence did you have at the time of the accident?*FullRestrictedLearnerInternationalNo licenceDo you have any conditions on your licence?*These will be printed on the back of your licence under the heading 'Conditions' Yes No What are the conditions?*In the 24 hours before the accident did you have any alcohol, drugs or prescription medication?* Yes No Please let us know the details of what you had, and when.*In the last five years have you had your licence endorsed, suspended or cancelled?* Yes No Please let us know the details.*In the last five years have you had a conviction or been fined for any driving offence (except parking infringements)?* Yes No Please let us know the details.*We'll need to talk to the driver to get their accident description and go through a few other questions. You can still complete this form, just give us their name and contact information and we'll get in touch with them directly.Driver Name* Prefix TitleMr.Mrs.Ms.MissDr. First Last Phone number* Additional phone number (optional) Email address (optional) Postal address (optional) Do you think the accident was someone else's fault?* Yes No Do you think the damage was someone else's fault?* Yes No Do you think the damage was someone else's fault?* Yes No Why do you think they're responsible?*Do you know where the water came from?*Please selectInternal water supply or disposal pipeHot water cylinder or other water supply tankOverflowStormwater/floodOtherDon't knowDescribe where the water came from.*Was this a one off event that happened suddenly?* Yes No Don't know Tell us when and how you first noticed the damage, and if there's evidence of rot or gradual deterioration.*What type of weather caused the damage?*Please selectWindHailLightningWaterLandslideCan the house currently be lived in?* Yes No Do you need help organising somewhere to stay?*If you need temporary accommodation we can help you organise this. Yes No Was your car locked and all windows closed?* Yes No Not sure Tell us a bit more about what wasn't locked or closed.*Was the alarm set?* Yes No Doesn't have an alarm Not sure Do you have all the keys for the car?*Select 'No' if one of the keys is missing or if someone else also has a key. Yes No Let us know who else has a key or the details if one is missing.*Do you know who was responsible for the damage?* Yes No What caused the fire?*If you're not sure, or the cause hasn't been confirmed yet, select 'Don't know'.Please selectArsonAccidentally litMechanical faultOtherDon't knowDid the fire service attend?* Yes No Do you know who was responsible for the fire?* Yes No Do you know who was responsible for the fire?* Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Do you have the details of the other driver and/or their vehicle?*It's OK if you only have some of the information, just enter the details you do have Yes No Name (optional) Prefix TitleMr.Mrs.Ms.MissDr. First Last Phone number (optional) Additional phone Email address (optional) Postal address (optional) Registration number (optional) Did they admit it was their fault?* Yes No Any other information e.g. their insurance company (optional)Has this been reported to the police?* Yes No Has this been reported to the police?* Yes No Has this been reported to the police?* Yes No This needs to be reported to the police. You can still complete this form but you’ll need to let us know the police details when you have them. We need to know the date reported, station reported to, and file or event number. When was it reported?* What station was it reported to?*File or event number (if known)If you're not sure leave this blank. You can let us know later. Did the police come to the accident scene?* Yes No Was a breathalyser or blood test carried out?* Yes No Has anyone been charged by the police?* Yes No Don't know Who has been charged and what have they been charged with?*Do you have the details of any witnesses?*A witness could be a passenger, someone walking by, or anyone else that saw the accident. Yes No There weren't any Was the witness:* Your passenger Someone else Name (optional) Prefix TitleMr.Mrs.Ms.MissDr. First Last Phone number (optional) Additional witness phone number (optional) Email address (optional) Did the police come out to your property?* Yes No Loss detailsIt's important you don't start repairs or incur any costs without our approval. If you need urgent assistance to make your home dry, secure, or weather tight, please finish this form then call us straight away on 0800 379 372. We have an after-hours helpline and are available 24/7. If you need to take action to prevent further damage in the meantime, please take photos first and don't throw away any damaged materials or items.What's your registration number?*To save you time, we'll use the registration number to look up your car details. If it's a newer vehicle we may not be able to find it, but you can still enter the make and model details. Do you ever use this as a work vehicle or to earn income?*Examples include: making deliveries transporting paying passengers use as a work vehicle for real estate agents, tradespeople etc Yes No Please provide information on:*what you usually use your vehicle forwhat you were using it for at the time of the lossAre you claiming for damage to your car?* Yes No Select all the areas of damage on your car* Bumper - front Bumper - rear Bonnet Door - front driver side Door - rear driver side Door - front passenger side Door - rear passenger side Panel - front driver side Panel - rear driver side Panel - front passenger side Panel - rear passenger side Boot Roof Lights - headlight, signal, brake Windscreen, Window glass Wing mirrors Tyres Interior Engine Undercarriage Other Let us know what is damaged or where the damage is.*What type of damage is it?*Is the car safe to drive?* Yes No Not sure Where is your car now?*Provide the location or the name, address and contact details of the tow yard or repairer.We have a network of preferred repairers. Just select your region and choose a repairer that suits*If you use one of our recommended repairers you’ll get a lifetime guarantee on those repairs. Each repairer has been approved by a Tower assessor so you can be confident you’ll receive a high standard of service. If there isn't a repairer that's convenient, or you have someone you usually use, select 'I want to use a different repairer'. Only our preferred repairers carry our repair guarantee. I want to use a different repairer* Yes No What's the name and address of the repairer?*Was someone else's vehicle damaged?* Yes No Was someone else's property/possessions damaged as well?* Yes No Please describe the damage*It's important you don't start repairs or replace any items without our approval. If you need to take action to prevent further damage please take photos first. You’ll also need to keep any damaged items until we’ve discussed this with you. Are you claiming for more than ten items?* Yes No You don’t need to enter them here; it’ll be easier to go through on the phone. Just skip the ‘What item are you claiming for?’ question and continue with the rest of the form. After you submit this form you’ll get a confirmation email with a link to download a loss inventory; Take a look to see the sort of information we’ll need. When your Claims Consultant has been assigned they’ll call you to go through the details. Content Claim items*nullDo you own all the items you're claiming for?* Yes No Please tell us which items you don't own, and who the owner is.*Do you have proof of ownership?*This includes things like receipts, warranties, or a copy of your bank statement. Yes No Being able to prove you own an item is a condition of your policy. We know this isn't always easy, so if you don't have it, that's ok. We'll give you a follow up call to talk through other ways you might be able to prove this.Was your house damaged?* Yes No Describe what's been damaged and how badly*Select areas of the house that have been damaged.*Select any of the areas that apply. If there isn’t a match pick ''Other'' then you’ll be able to enter a description. Bedroom/s Bathroom/s Kitchen Lounge Dining room Laundry Roof Spouting/gutters External walls/cladding Garage Patio/porch Shed Other Describe the area/s of the house that have been damaged:*What type of damage is it?*Have you already contacted a repairer or arranged for someone to come to the house?* Yes No Let us know the name and contact details of the company/ repairer and if they've already attended or done any work.**Are you claiming for damage to someone else's property?*Select yes if there was any damage to someone else's property, even if the accident wasn't your fault. Yes No Please tell us what happened, the damage caused, and why you think you're responsible.*Do you have their details?*It's OK if you only have some of the information, just enter the details you do have Yes No Name (optional) Prefix TitleMr.Mrs.Ms.MissDr. First Last Phone number (optional) Additional phone number (optional) Email address (optional) Postal address (optional) Do you need to claim on any of your other Tower policies because of this event?*If something else you own was affected and it's insured with Tower let us know- we can lodge a claim for this too. Yes No What sort of policy, or policies, do you want to claim on?* House Contents If you need urgent repairs to make your home dry, secure, or weathertight, please finish this form then call us straight away on 0800 379 372. We have an after-hours helpline and are available 24/7.Let us know what happened and the details of any loss or damage.* Your claim summary This is a summary of your information only. If you want to review or change anything you can click on a page in the progress bar to go back to it, or just use the ‘Back’ button. Declaration I declare the information provided in this form is true and correct and understand Tower will use this to assess my claim. I give Tower permission (pursuant to the Privacy Act 2020) to disclose to and/or obtain from other parties, information to process my claim and for other insurance related purposes. This includes but is not limited to other insurance companies, the Insurance Claims Register, repairers or suppliers, and the New Zealand Police. For further information please refer to our Privacy Policy on our website. I understand my obligations to provide correct and complete information. If I do not, I understand that this may affect my rights under my policy.I have read and accept the declaration:* Yes No
