To lodge a claim, please answer the following questions. All questions marked with an * are mandatory.
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What is the current work fitness of the injured worker? *
Did the worker receive medical treatment? For example, GP consult, Physiotherapy etc (on site first-aid not included)? *
Has the worker lost any time off work? *
Please enter your policy number and if appropriate the cost centre and risk number
Policy number *
Please enter your address details
Business name *
Suburb / Town *
What is the size of the workplace?
Number of employees *
Is the above address also your mailing address? *