Acorn Notebook Insurance - Insurance for Laptops and Computers

Acorn Notebook Insurance - Insurance in a nutshell!


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Claim Form

To ensure your claim is dealt with as quickly as possible, please complete this form in full.

Your claim will be delayed if you do not complete all relevant sections. All claims must be referred to the Claims Administrators before you take any action. Failure to do so will invalidate your claim.

For a claim that is not capable of repair e.g. following theft, the Claims Administrators will instruct our authorised supplier to arrange replacement to comply with general condition 2 (basis of settlement) of the Certificate.

Fields marked with an * are mandatory.

Policy Number *

Purchase date of insurance *

WARNING: If in the course of claim validation, misrepresentation of the facts is discovered we will consider this as fraud. Details of all such cases will be passed to the appropriate agencies for action.

Section 1: Name of Insured

Title

Name *

Company/School

Address

Tel. Work *

Tel. Home

Tel. Mobile

Email *

If you are claiming for damaged property click here

If you are claiming for stolen property click here

Section 2: Damage
(please ensure all data on the hard drive is backed-up prior to collection)

Who was in charge of the equipment when damage occurred:

How the damage occurred:

Date and time when the damage occurred:

Location of where the damage occurred:

Date, time and by whom the damage was discovered:

What damage has occurred?

Section 3: Theft

Who was in charge of the equipment when the theft occurred:

Date and time the theft occurred:

Location where the theft occurred:

Date and time when it was discovered:

Do your suspicions rest on anyone? If so on whom?

Date, time and location when the property was last seen:

In all cases the Police must be advised within 24 hours. Please state the following:

*Date Reported

*Name of Police Station

*Tel. No of Police Station

*Police Crime Number

*N.B. Failure to provide will invalidate claim.

Section 4 *: Full description of property damaged or stolen (including Serial Number(s))

Section 5: Is there any other insurance covering the property concerned?

Yes

If yes, please supply details below

Section 6: Are you a taxable company for VAT purposes?

Yes

If yes, can you recover the value added tax which will be included in the cost of repairing or replacing the property for which you are claiming? If not, please state % and reason

DECLARATION: The information I have provided is true and accurate to the best of my knowledge. I understand that Acorn Notebook Insurance may ask for further information in support of my claim. I agree to provide any further information if requested. I understand Acorn Notebook Insurance may share information with other insurance providers in order to prevent fraudulent claims

Please tick this box to confirm you have read the declaration *

Please tick this box to confirm you will be providing your proof of purchase for the equipment you are claiming for *