Liability Claim Form Information
Note: This form must be completed by the policyholder NOT the injured party. To be completed when accident causes damage to property or injury to a member of the public.
The Privacy Act 1988 requires Action Insurance Brokers P/L to make the following disclosure before collecting personal information about
you after 21 December 2001:
- Action Insurance Brokers P/L collects personal information in order to provide it’s various services which include insurance broking, claims management, risk management consultancy, underwriting management, and reinsurance.
- If the personal information Action Insurance Brokers P/L requests from you is not provided, Action Insurance Brokers or any involvedthird party may not be able to provide the appropriate services.
- Action Insurance Brokers P/L discloses personal information to third parties who are involved in the provision of our services. For example, in arranging and managing your insurance needs Action Insurance Brokers may provide information(including sensitive information such as health information) to insurers, reinsurers, other insurance intermediaries, it’s advisors such as loss adjusters, lawyers and accountants, and other parties involved in the claims handling process. By signing this form and continuing to deal with us, you confirm on your behalf and/or on behalf of those you represent consent to Action Insurance Brokers and these parties collecting, using and disclosing personal and sensitive information about you.
- Action Insurance Brokers P/L has a duty to maintain the confidentiality of it’s client’s affairs which includes their personal information. Our duty of confidentiality applies except where disclosure of your personal information is with your consent or required by law.
- Action Insurance Brokers P/L may make use of your personal information to provide you with information about it’s products and services.