Follow the steps to complete your application efficiently.

1. Press the ‘Get Form’ button to access the application form and open it in your preferred editor.
2. Begin by entering your personal details in the ‘Your details’ section. This includes your first name, last name, date of birth, contact information, and Medicare number. Double-check to ensure accuracy in this vital information.
3. Provide information about the incident in the ‘About the accident and your injuries’ section, including the police accident report number, the details of the accident, and your role (driver, passenger, etc.). Attaching any supporting documents, such as photos or witness details, can be helpful.
4. In the ‘About your health’ section, outline any injuries sustained from the accident. Attach any relevant medical treatment evidence, including invoices and reports completed by your doctor.
5. If applicable, fill out the ‘About your employment and income information’ section to request recovery of lost income. Include your employment details at the time of the accident and any proofs like pay slips if required.
6. In the ‘Collection of personal and health information’ section, provide consent for the necessary collection and sharing of your information to process your application.
7. Complete the ‘Declaration and authorisation’ section by signing and dating the form, confirming that all information is true and correct. If you are completing the form on behalf of someone else, fill out the authorization section accordingly.
8. Review the completed form and ensure that all sections are filled accurately. Gather any required attachments as outlined in the checklist.
9. Finally, submit the application form along with all attachments to the relevant insurer. You may save changes, download, print, or share the form as needed during this process.

Complete your application online to ensure timely processing of your claim.