Claims Procedure

How to make a claim?

Below is information on how to make a claim under the Personal Accident policy. If you wish to make a claim or notify an incident for General Liability, Professional Indemnity or Management Liability, please contact Gow-Gates immediately.

Personal Accident Claims

Steps to follow:

  1. Obtain a claim form
  2. Complete the Claim Form
  3. Lodge the claim form
  4. Lodge additional documentation as required

Step 1: Obtain a claim form

Click here to obtain the Personal Accident Claim Form:

pdficon_small Pony Club Personal Accident Claim Form - Member
pdficon_small Pony Club Personal Accident Claim Form - Voluntary Helper

Step 2: Complete the Claim Form

The insured person is to fully complete all sections of the claim form. In addition, the following people will need to complete their relevant sections:

  • The Medical Report on pages 7, 8 and 9 will need to be completed by your treating doctor.
  • The Declaration and Authorization by Injured Person, on page 4, must be completed and signed by the injured person.
  • If you are claiming for loss of income, you will need to have your employer complete the Employer’s Statement on page 6 of the form.
  • If the injury occurred at a club event, the club secretary or treasurer will need to complete and sign the Incident Report Form, having verified all the details completed in the form.
    PCAV Incident Report Form.pdf   (For Victoria)
    Incident Report Form 1415.pdf   (For South Australia and Tasmania)
  • A photocopy of your membership card must be included when lodging the claim form.

Step 3: Lodge the Claim Form

The claim form needs to be lodged to Gow-Gates Insurance Brokers within 120 days of the injury.

Claims Department
Gow-Gates Insurance Brokers
GPO Box 4731
SYDNEY   NSW   2001

The claim form will be acknowledged within 14 days by Insurers. This acknowledgement will include a unique claim number which can be used when lodging additional documentation.

Step 4: Submit additional paperwork

In order to claim, the following documentation will/may be required by Insurers in addition to the claim form.

  • Receipts for paid Non-Medicare Medical and/or Physiotherapy Expenses
  • Health Fund rebate statements
  • Doctors Certificates confirming the period of incapacitation
  • Proof of Earnings documentation
  • Any other documentation requested.

Don’t wait for the above documentation before submitting the claim form to Gow-Gates as this delays the claims process and means that your claim payment will be slower.