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Equine Insurance Calculator
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1800 076 277
Motor Claim
Client Information Form
Motor Claims Client Information Form
Name
*
Name
First
First
Last
Last
Email
*
Phone
*
Policy Number (if known)
Claim Type
Windscreen
Single Vehicle Accident
Multi Vehicle Accident
Date of Loss
*
Time of Loss
*
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
Location of Incident
*
Description of Incident
*
Third Party Information (please tick if applicable)
Third Party Information (if applicable)
Third Party Information
Name
Phone
Vehicle Make (e.g. TOYOTA)
Vehicle Colour
Vehicle Registration Number
Documents to upload
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Maximum file size: 25MB
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Protect what Matters Most
Fitton Insurance Brokers Australia provide comprehensive coverage, including Horse, Agriculture, Crop, Livestock, Farm, and Cattle Insurance, among other specialised policies.
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