BEFORE YOU START

If this is a windscreen/window glass claim and you are happy to use Smith & Smith just click this link to make a booking: www.smithandsmith.co.nz/builtin (no claim form is required).

This form will ask for specific information, for example, details from the driver's license and their driving history, copies of documents such as a Police Acknowledgement (if applicable) and the details of any third party.

If you were not the driver or do not have all this information to hand you may wish to: a) wait and compile this information before continuing with the form, or b) complete as much as you can now, then save and email yourself a link to the form to finish later. You can also send this link to the driver or any other person to add their own information.

You can save the form at any time by clicking on the  icon at the bottom of the page.

BEFORE YOU START

 This form will ask for specific information, for example, copies of documents such as a Police Acknowledgement (if applicable), repair quotes, photos and the details of any third party.

If you do not have all this information to hand you may wish to: a) wait and compile this information before continuing with the form, or b) complete as much as you can now, then save and email yourself a link to the form to finish later. You can also send this link to any other person to add their own information.

You can save the form at any time by clicking on the  icon at the bottom of the page.

Please note:

• The insurer does not admit liability by the issue of this form.
• Any occurrence or claim must be notified to the insurer immediately.
• You must not incur any expenses without the written consent of the insurer.
• You must not make any admission of liability, offer of settlement, promise or payment without the written consent of the insurer.
• Failure to provide full and correct information could result in your claim being delayed or not being accepted by the insurer.
• Please retain damaged goods in case inspection is required.
• Please attach estimates in support of repairs as appropriate along with any other relevant documentation.