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NTI Insurance Claim Form
Your Details
Business Name
*
ABN
*
Name
*
First
Last
Email
*
Contact Number
*
Mobile preferred
Insurance Claim Details
NTI Reference
*
As shown on your KIS invoice and NTI policy email
Invoice value of goods (excluding GST)
*
Invoice value of freight (excluding GST)
*
Connote Number
*
Carrier
*
Allied
Aramex
CTI
Bonds
Couriers Please
Followmont
Followmont NSW
Hi Trans
Northline
Sadleirs
TNT
TGE IPEC
TGE Priority
TGE Express
PEP Transport
Vision
Reason for credit request
*
Damages
Lost in Transit
Theft
Date the damage was discovered
*
Where is the current location of the damaged items?
*
Was the theft reported to the police?
*
Yes
No
Date reported to the police
*
Attach repair quote
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Attach invoice for goods
*
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Attach invoice for freight
*
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Attach the WPL/WOP letter
*
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Attach police report for stolen items
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Attach photographic proof of the damage
*
Drop files here or
Select files
Accepted file types: jpg, pdf, png, Max. file size: 2 MB.
Additional Information
*
Additional Information
*
Additional Information
*
Consent
*
I agree to KIS sharing this information with NTI
*
I acknowledge that the information I have submitted to support the lodgement of this claim, including any supporting documents, are true and correct.
*
I agree that NTI reserves the right to request additional information pertaining to this claim.
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