Customer Information Vehicle Hail Damage Assessment Form

To proceed with any insurance claims,

Step 1: Contact your insurance company and lodge a claim – we require a claim number.

Step 2: Please complete the following form on this page below.

Step 3: Contact us to make the FREE quotation and we will take the necessary compliant pictures of your vehicle for the insurance companies.

Name *

First

Last
Email Address *
Address *
Suburb *
State
Post Code
Phone Number *
Phone Number (Secondary Contact eg Spouse)
Vehicle Information (Make, Model,Year, Colour) *

Toyota, Camry, 2015, White
Registration *
Are you open to going through insurance? *

Yes No
Claim Number
Insurance Excess
Insurance Company (choose no insurance if none or not going through insurance) *
If Insurance not listed please specify
Date (and Time) of Hail Damage Event
Location of Hail
Provide a picture of your vehicle with registration (optional)
Select Image
Further Comments or Requests
I consent to the information provided here to be used for the purposes of the quotation *

Click here to agree

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It is possible for some quotations to allow us to pay your excess – certainly contact us for further details.

If you can promote us as your repairer you are eligible for our excess reward.