Lodge a claim

If the Category that a User is authorised to access permits that User to upload any materials onto the VMIA Portal, that User must upload the materials in the format specified in the relevant section of the VMIA Portal.

I declare that to the best of my knowledge and belief the information in this form is true and correct and I have not withheld any relevant information.

I consent to VMIA using personal information I have provided on this form for the purpose of processing the claim. However, I understand that if I choose not to provide the required details, this is my choice and that VMIA may not be able to process the claim.

I consent to VMIA disclosing personal information to other insurers or as required by law.

I consent to VMIA also disclosing personal information to and/or collecting additional information from investigators, legal advisers, medical advisers, actuaries or other advisers whom VMIA may engage to assist in processing this claim.