Important Notices

Your PDS

This contract of insurance is arranged by Dawes Underwriting Australia Pty Ltd trading as Dawes Motor Insurance (ABN 18 050 289 506, AR No. 342982) ('Dawes'), an Authorised Representative of SGUAS Pty Ltd (ABN 15 096 726 895, AFSL 234437) ('SGUAS') who in turn acts as under binding authority as agent for the insurer of the product, Allianz Australia Insurance Limited (ABN 15 000 122 850, AFSL 234708) ('Allianz').

General Insurance Code of Practice

The General Insurance Code of Practice was developed by the Insurance Council of Australia to further raise standards of practice and service across the insurance industry.

You can obtain more information on the Code of Practice and how it assists you by contacting us.

Your Duty of Disclosure

Before you enter into this insurance with Dawes, you have a duty of disclosure under the Insurance Contracts Act 1984 (Cth) ('the Act').

The Act imposes a different duty the first time you enter into a contract of insurance with Dawes to that which applies when you vary, renew, extend or reinstate the contract.

This duty of disclosure applies until the contract is entered into (or renewed, varied, extended or reinstated as applicable).

Your Duty of Disclosure when you enter into the contract with Dawes for the first time

When answering Dawes' specific questions that are relevant to their decision whether to accept the risk of the insurance and, if so, on what terms, you must be honest and disclose to them anything that you know and that a reasonable person in the circumstances would include in answer to the questions.

It is important that you understand you are answering Dawes' questions in this way for yourself and anyone else whom you want to be covered by the contract.

Your duty of Disclosure when you renew the contract

Where applicable, Dawes will tell you what your renewal duty of disclosure is prior to each renewal.

Your Duty of Disclosure when you vary extend or reinstate the contract

When you vary, extend or reinstate the contract with us, your duty is to disclose to Dawes every matter that you know, or could reasonably be expected to know, is relevant to our decision whether to accept the risk of the insurance and, if so, on what terms.

What you do not need to tell us

Your duty however does not require disclosure of any matter:

that diminishes the risk to be undertaken by Dawes; or
that is of common knowledge; or
that Dawes know or, in the ordinary course of their business as an insurer, ought to know; or
as to which compliance with your duty is waived by Dawes.

Non-disclosure

If you fail to comply with your duty of disclosure, Dawes may be entitled to reduce their liability under the contract in respect of a claim, cancel the contract or both.

If your non-disclosure is fraudulent, Dawes may also have the option of avoiding the contract from its beginning.

Failure to comply with your duty of disclosure, especially concerning your driving history, including, but not limited to, speeding fines, could severely affect the result of any subsequent claim made on the policy and could lead to a claim being declined.

Privacy Notice

In this Privacy section 'Dawes' means Allianz Australia Insurance Limited, SGUAS and Dawes unless specified otherwise.

Dawes give priority to protecting the privacy of your personal information. They do this by handling personal information in a responsible manner and in accordance with the Privacy Act 1988 (Cth).

How Dawes collect your personal information

Dawes usually collect your personal information from you or your agents. Dawes may also collect it from their agents and service providers; other insurers and insurance reference bureaus; people who are involved in a claim or assist Dawes in investigating or processing claims, including third parties claiming under your policy, witnesses and medical practitioners; third parties who may be arranging insurance cover for a group that you are a part of; law enforcement, dispute resolution, statutory and regulatory bodies; marketing lists and industry databases; and publicly available sources.

Why Dawes collect your personal information

Dawes collect your personal information to enable them to provide their products and services, including to process and settle claims; offer their products and services and those of their related companies, brokers, intermediaries and business partners that may interest you; and conduct market or customer research to determine those products or services that may suit you. You can choose not to receive product or service offerings from Dawes (including product or service offerings from them on behalf of their brokers, intermediaries and/or their business partners) or their related companies by calling the Allianz Direct Marketing Privacy Service Line on 1300 360 529, EST 8am to 6pm Monday to Friday, or going to Allianz website's Privacy section at www.allianz.com.au, SGUAS on +61 2 9307 6656 or going to the SGUAS website's Privacy section at www.steadfastagencies.com.au, or Dawes on 1300 188 299 or going to the Dawes website's Privacy section at www.dawes.com.au.

Who do Dawes disclose your personal information to

Dawes may disclose your personal information to others with whom they have business arrangements for the purposes listed in the paragraph above or to enable them to offer their products and services to you. These parties may include insurers, intermediaries, reinsurers, insurance reference bureaus, related companies, Dawes' advisors, persons involved in claims, external claims data collectors and verifiers, parties that Dawes have an insurance sheme in place with under which you purchased your policy. Disclosure may also be made to government, law enforcement, dispute resolution, statutory or regulatory bodies, or as required by law.

Disclosure overseas

Your personal information may be disclosed to other companies in the Allianz Group, business partners, reinsurers and service providers that may be located in Australia or overseas. The countries this information may be disclosed to will vary from time to time, but may include Canada, Germany, New Zealand, United Kingdom, United States of America and other countries where the Allianz Group has a presence or engages subcontractors. Dawes regularly review the security of their systems used for sending personal information overseas. Any information disclosed may only be used for the purposes of collection detailed above and system administration.

Access to your personal information and complaints

You may ask for access to the personal information Dawes hold about you and seek correction by calling Allianz on 1300 360 529, SGUAS on +61 2 9307 6656 or Dawes on 1300 188 299 8am - 6pm, Monday to Friday. The Privacy Policies contain details about how you may make a complaint about a breach of the privacy principles contained in the Privacy Act 1988 (Cth) and how Dawes deal with complaints. Privacy Policy for Allianz is available at www.allianz.com.au. Privacy Policy for SGUAS is available at www.steadfastagencies.com.au. Privacy Policy for Dawes is available at www.dawes.com.au.

Telephone call recording

Dawes may record incoming and/or outgoing telephone calls for training or verification purposes. Where Dawes have recorded a telephone call, they can provide you with a copy at your request, where it is reasonable to do so.

GST

If you are not registered for GST, in the event of a claim Dawes will reimburse you the GST component in addition to the amount that they pay. The amount that Dawes are liable to pay under this policy will be reduced by the amount of any input tax credit that you are or may be entitled to claim for the supply of goods or services covered by that payment.

Therefore the value and limits of liability noted in your policy schedule are exclusive of any input tax credit which you are or would be entitled to claim.

If you are entitled to an input tax credit for the premium you have paid, you must inform Dawes of the extent of that entitlement at or before the time you make a claim under this policy. Dawes will not indemnify you for any GST liability, fines or penalties that arise from or are attributable to your failure to notify them of your entitlement (or correct entitlement) to an input tax credit on the premium. If you are liable to pay an excess under this policy, the amount payable will be calculated after deduction of any input tax credit that you are or may be entitled to claim on payment of the excess.

If you are unsure about the taxation implications of this policy, you should seek advice from your accountant or tax professional.

Find A Repairer

We would recommend the services of a member of Dawes' preferred repairer network. To find the closest to you, please click here https://dawes.com.au/claims/ to assist you in your search

To ensure prompt attention to your claim, please complete this form in full and submit as soon as possible.

NOTE:

Ensure the accident description is accurate and all questions on the claim form have been answered in full
Please obtain a quotation from a repairer of your choice and submit with this form or as soon as possible thereafter
Repairs may not be commenced without authority from Dawes Motor Insurance, other than emergency repairs up to the value of $1,000 (incl. GST) as described and subject to the terms and conditions set out in the PDS.

Insured's Details

Your full name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your residential address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your email address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your phone number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your policy number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your policy expiry date: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Insured Motor Vehicle Details

Year: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Model: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Registration no: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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VIN/chassis number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Engine number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Registration expiry: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Speedometer reading: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Type of use: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Are you entitled to claim an Input Tax Credit (ITC) on the GST portion of the premium applicable to the policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please supply your ABN: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please specify the ITC %: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Damage Sustained:

Description of the area(s) of damage on your vehicle: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Was your vehicle towed? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please provide the address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Date of accident/theft: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Time of accident/theft: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Place of accident/theft: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Road conditions: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Has the insured vehicle been recovered? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Your insured motor vehicle

Estimated speed 100m prior to impact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Estimated speed on impact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was your insured motor vehicle on the correct side of the road before the collision? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was your insured motor vehicle on the correct side of the road after the collision? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Other vehicle

Estimated speed 100m prior to impact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Estimated speed on impact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was their motor vehicle on the correct side of the road before the collision? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was their motor vehicle on the correct side of the road after the collision? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Accident Description:

Please provide a detailed description of how the damage occurred {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Details of Driver of Insured Motor Vehicle:

Please provide a copy of the relevant driver's licence via the file upload section on Page 7 of this form

Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Date of Birth: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Licence no: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Licence expiry date: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Years licence held: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Licence type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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In the last 5 years have you had a motor vehicle stolen? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please provide details: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

In the last 5 years have you had your licence suspended, cancelled or been disqualified from riding/driving or had a good behaviour period imposed? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please provide details: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

In the last 5 years have you had any prior accidents and/or claims? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please provide details: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Police or Traffic Officer Details:

Did the police attend the scene? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Officer's name and station attached to: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Was a breathalyser or blood alcohol test taken? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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What was the reading? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was the accident/theft reported to the police? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Police Report/Event Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Was any alcohol, medication or drugs consumed in the 12 hours prior? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Please provide details: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Was the driver driving with the knowledge and consent of the insured? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Who was responsible for the collision? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Did any driver admit liability? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Who? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Has a fine or on the spot fine been imposed? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Passenger Details:

Passenger {binding ItemNumber}

Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Witness Details:

Witness {binding ItemNumber}

Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Other Vehicle Details:

Vehicle {binding ItemNumber}

Owner's name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Owner's address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Owner's mobile phone no: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Insurer: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Vehicle registration no: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Vehicle make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Driver's name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Driver's address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Driver's mobile phone no: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Property Damage:

Damage to property (fences, buildings, etc.) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Persons injured: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

File Upload {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Declaration

I declare that, to the best of my knowledge and belief, the information in this form is true, complete and correct and I understand the claim may be refused or reduced if information is false or withheld.

I understand that I may have to provide relevant documentation to enable complete consideration of my claim.

I consent to Dawes, SGUAS and the insurer using the personal information (including sensitive information) I have provided on this form for the purposes of processing my claim. I consent to the disclosure of personal information (including sensitive information) to third parties in order to process my claim. I consent to the disclosure of any personal information (including sensitive information) overseas where it is reasonably necessary for the processing of my claim. I understand that if this consent is not given Dawes, SGUAS and the insurer will not be able to process my claim.

Signature of owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Signature of owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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