PLEASE READ THESE GUIDANCE NOTES BEFORE COMPLETING THE CLAIM FORM

1. Complete and e-mail the claim form to claims@divemasterinsurance.com within 31 days of the claim occurring.

2. In the event of damage, take your equipment to your local dive shop for inspection and an estimate to repair
     if necessary. Submit the estimate with your claim form.

3. In respect of ACCIDENTAL LOSS of items over £100 in value these must be reported to the Police Station
     nearest to the location of the loss within 31 days of the loss occurring, together with a description and value
     of the missing item(s) and any serial number(s) applicable.

4. Theft must be reported immediately to the nearest Police Station giving a description of the stolen item(s)
    and value(s).
    Identifying marks and serial numbers must be given to the Police in writing within 31 days of the theft occurring.
    A crime reference report must be obtained and must be forwarded to us within 31 days of the theft occurring.

5. Please ensure that you complete the GENERAL DETAILS and all sections relevant to your claim.

6. Once you have completed your online claim form, please post original of all documents required
    to support a claim to:
    Dive Master Insurance Consultants Ltd.
    17-23 Rectory Grove
    Leigh-on-Sea
    Essex SS9 2HA


GENERAL DETAILS

First name Surname
House name / number   Street
Post code   Town / County
Country   Telephone
Email   Fax
Date of birth   Nationality
Diver qualification Occupation
Policy number Date insurance purchased
Place of
damage / theft / loss		 Date and time of
damage / theft / loss
Name of buddy Address of buddy
Name of Dive guide
supervisor / master
instructor 		Address of Dive guide
supervisor / master /
instructor
Name of boat Registration of boat
       
State the type of diving you were engaged in
at the time of the incident / loss		 Club Private Wreck Other
Drift Expedition Reef
Please explain fully if you were engaged in any other type of diving
Planned depth of dive Maximum depth reached
Duration of dive Size of bottles used
Surface conditions
Was damage / theft / loss reported to: If No to any, please state reason why in the box below
the courier Yes No
the airline Yes No
the police Yes No
Please explain fully the circumstances of the damage / theft / loss
 
Insurers contribute to the settlement of each others claims, which shares costs and helps to keep premiums down.
Is there any other relevant policy that may cover this claim? (e.g. household or travel insurance).
If "yes" please provide details in the boxes below.

Policy number
Insurers name
Insurers address
Have you ever made an insurance claim for personal property? Yes No
If Yes, please give precise details in the box below        
Has a claim been submitted to any other insurer or any authority in respect of this loss? Yes No
If Yes, please give precise details in the box below        
Details of other claims / insurers / authorities / previous losses

Detailed estimate of repair / replacement cost

Please provide details of any damage that was caused to a third party (personal / property)

If as a result of this a claim has been made againt you, please provide details of claimant and amount claimed

Names and addresses of all persons involved and any witnesses (it is important that these are obtained)

Please note that any correspondence received from any third party is to be forwarded to us unanswered.

I confirm that all information supplied in this form is true and correct in every aspect and that no relevant information has been withheld. On settlement, all rights of subrogation, salvage and recovery are transferred
to the insurer and / or their loss adjuster.

DETAILS OF DOCUMENTS REQUIRED TO SUPPORT CLAIMS
We require original copies of all documents and cannot accept photocopies or faxes

Insurance Certificate.
Travel tickets, (Airline, Ferry, Coach, etc) unless returned to the Tour Operator for refund.
Travel itinerary / dive holiday / liveaboard itinerary.
Police report / Representative's report.
Insurers require claims to be supported by evidence of ownership and original purchase price. Please mail original purchase receipts, guarantee cards, instruction manuals, credit card slips / credit card statements or original insurance valuations to confirm ownership of the items being claimed.
Replacement estimates / receipts do not prove ownership and are not acceptable.
In the event of property being lost by the carrier: the Property Irregularity Report, tickets and baggage tags.
If claiming for damaged items, please obtain an estimate of repair or confirmation that the item is beyond economic repair in writing from an authorised dealer or the manufacturer of the item.

Please print a copy of this form and / or the formmail that you will receive upon submitting this form.

 

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