Sport Details

National Association

State Assoc/League

Local Assoc/League

Association Number

Club

Sport

Policy Number(If known)

Claimant Details

Firstname

Surname

Home Address

Address Line 1

Address Line 2

Suburb

State

Postcode

Country

Contact Details

Firstname

Surname

Postal Address

Address Line 1

Address Line 2

Suburb

State

Postcode

Country

Business Hours

After Hours

Mobile

At least one contact number must be entered

Injury Type

Area

Type

Side

Please provide a detailed description of how the injury occurred ()

At the time of the injury, were you:

Injury Address

Address Line 1

Address Line 2

Suburb

State

Postcode

Country

All information is collected in accordance with our privacy policy available here.

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Personal Accident Claim Form Request

Thank you for submitting your Personal Accident Claim Form Request.

When contacting the Claims Department please quote your reference number .

A Personal Accident Claim Form will be emailed to you within 5 business days. If you have provided us with your email address, PDF copies of the relevant forms will be sent electronically.

If you have any questions regarding your claim during the claims process, please contact us -

Sportscover Claims Hotline: 1300 134 956

Outside Australia: +61 3 8562 9100

Email: asiapac.claims@sportscover.com

Once you have received your Claim Number and Internet Access Pin you will be able to track the progress of your claim online via our Claims Progress Login .

Additional Information

Below is some useful information to help you make your Personal Accident Claim and understand the cover provided.

Frequently Asked Questions Privacy Statement

Personal Accident Claim Form Request

Sport Details

Claimant Details

Home Address

Contact Details

Postal Address

Injury Details

Injury Type

Injury Address

Personal Accident Claim Form Request

Additional Information

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