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Are you the insurance account holder?
Driver’s License/Passport Identification Number:
Were you in possession of device?
Relationship to account holder:
Regular User date of birth:
Authorise Regular User on insurance claim?
Regular User’s Driver’s License/Passport Identification Number:
Insured IMEI Number / Serial Number:
Has your device been exchanged under warranty or repair?
Make / Model / Colour of insured device:
Has device been Lost or Stolen?
Was the device lost or stolen within Australia or whilst Overseas?
Date you last saw the device:
Time you last saw the device:
Where exactly was the device the last time you saw it?
What was your location the last time you saw the device?
Date you realised device was missing?
Time you realised device was missing?
Your location when you realised device was missing:
Detailed explanation of events:
What Mobile Number was in the device:
What telco network does the this Mobile Number work on?
Since the loss/theft have you had your SIM card replaced?
Have you obtained Police incident or event number?
Police incident or event number:
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Risk Insure exercises utmost good faith. If at anytime during the claims process it is suspected that anyone is attempting to defraud the insurer, Risk Insure will instigate legal action to prosecute those responsible for fraudulent activity and involve the Australian Federal Police and other relevant Australian Authorities.