To ensure your claim is dealt with as quickly as possible, please complete this claim 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.
The claim form will need to be completed in full by the named Policyholder. If the Policyholder requires someone else to complete the form on their behalf, then due to the Data Protection Act we will need the name and address of the person who will complete the form on the Policyholder's behalf. This information will need to be provided by the Policyholder in writing either by post, fax or e-mail.
Fields marked with an * are mandatory.
PLEASE DO NOT SEND YOUR EQUIPMENT TO US
Please ensure your data is backed up prior to collection of your equipment.
The details you supply will be used to administer your claim and to combat fraud. The answers to the questions will be the basis of the assessment of your claim. All material facts must be disclosed. A material fact is one that is likely to influence us in the assessment or acceptance of this claim, or one that is likely to influence our consideration of cover under the terms of your policy. If you are in any doubt as to whether a fact is material, you must disclose it.I/We submit my/our claim for the amounts stated and declare that, to the best of my/our knowledge and belief, all information given on this form is true and correct, as will be my/our response to any further enquiries made by CompuCover.
Please tick the box to confirm you have read the declaration*
PLEASE ENSURE YOU COMPLETE THE EQUIPMENT DETAILS BELOW