Western Australia
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- TAS
- ACT
Claim forms for email, postal or fax lodgements
Workers Compensation Claim Form
345 KB,
pdf
When an injured worker sustains an injury, the Workers Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the First Medical Certificate to the Employer so that they can then lodge it with the Insurer.
Employer's Report of Injury Claim Form
211 KB,
pdf
The Employer’s Report Form is to be completed by the Employer once an injured worker lodges a claim for Workers compensation. The claim form assists the Insurer in the decision making process.
Injury on the Journey Claim Form WA
238 KB,
pdf
The Form is required to be completed when a worker is involved in a Motor Vehicle Accident whilst they are in their employment.
Recurrence / Aggravation of Injury Claim Form
225 KB,
pdf
The Recurrence / Aggravation of Injury Claim Form needs to be completed by the injured worker if they sustain a recurrence or aggravation of the original injury.
Workplace Fatality Claim Form
460 KB,
pdf
When a worker has died as a result of a work related injury a claim for compensation can be made by the worker’s dependants under the Workers Compensation and Injury Act 1981. The dependant is required to complete the Workplace Fatality Claim Form and provide this to the Employer to lodge with the Insurer.
WorkCover return to work program template
60 KB,
docx
The Return to Work Program Template is required to be completed by the Employer when an injured worker is back at work on light/restricted duties. The program is signed by both the Employer and the injured worker.
Work Restrictions Form
217 KB,
pdf
This Form is utilised to determine what the injured worker’s capabilities are to be able to perform their normal duties.
Request for Income Compensation Reimbursement Form
185 KB,
pdf
The Request for Income Compensation Reimbursement Form is to be completed by the Employer so that the Insurer can reimburse the Employer for the time off work that an injured worker has as a result of the injury.
Injury Management System Template
133 KB,
pdf
The template can be used by the Employer to demonstrate that they have an injury management system and policy in place. The document should be placed where readily accessible by staff.
Section 32 Declaration
186 KB,
pdf
The Section 32 Declaration needs to be completed by the injured worker if they commence paid work with another employer after making a claim, or while receiving income compensation.
Workers Compensation Important Information
256 KB,
pdf
Important information for worker’s about privacy, vulnerability and Zurich’s internal dispute resolution process.
Email: wcclaims.wa@zurich.com.au
Post: Zurich Financial Services, PO Box 442, West Perth WA 6872
Fax: 08 9261 1390
Tasmania
Claim forms for email, postal or fax lodgement
Tasmanian Early Injury Notification Form
961 KB,
pdf
This form is required to be completed and forwarded to Zurich Australian Insurance Limited within three (3) days of becoming aware of a work injury that may result in a claim or incapacity to the worker.
Tasmanian Worker’s Claim for Compensation
205 KB,
pdf
When an injured worker sustains an injury, the Workers Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the First Medical Certificate to the Employer so that they can then lodge it with the Insurer.
Request for Wage Reimbursement
476 KB,
pdf
The Wages Reimbursement Form is to be completed by the Employer so that the Insurer can reimburse the Employer for the time off work that an injured worker has as a result of the injury.
Email: wcclaims.tas@zurich.com.au
Post: Zurich Financial Services, GPO Box 801 Canberra ACT 2601
Fax: 1800 074 778
Call 02 6247 3766
Australian Capital Territory
- From 4:00pm 30 September 2022 Zurich will no longer offer Workers Compensation Insurance in ACT. Zurich will continue to support our existing ACT customers during the run-off period and are working closely with WorkSafe ACT to ensure a smooth transition. Visit WorkSafe ACT for more details.
- Western Australia and Tasmania are unaffected, and Zurich remains committed to providing Workers Compensation Insurance in those states
- For further information please contact wcunderwriting.act@zurich.com.au or telephone 02 5111 5906.
Claim forms for email, postal or fax lodgement
Early Injury Notification Form
97 KB,
pdf
The employer uses this form to provide information about an injury to Zurich within 48 hours of an injury occurring.
ACT - Employees Compensation Claim Form
511 KB,
pdf
When an injured worker sustains an injury, the Employees’ Compensation Claim Form needs to be completed by the injured worker to enable them to lodge a claim for Workers Compensation. Upon completion the injured worker is required to provide the claim form along with the Certificate of Capacity to the Employer so that they can then lodge it with the Insurer.
Injury on the journey claim form - ACT
569 KB,
pdf
The Form is required to be completed when a worker is involved in a Motor Vehicle Accident whilst they are in their employment.
Email: wcclaims.act@zurich.com.au
Post: Zurich Financial Services, GPO Box 801 Canberra ACT 2601
Fax: 1800 074 778
Call 02 6247 3766
Claim forms for email or postal lodgement
Group Journey Injury Insurance Claim form
698 KB,
pdf
Golf - Personal Accident Claim form
61 KB,
pdf
Email: ah.claims@zurich.com.au
Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059
Fax: 02 9995 4093
Call 132 687
Claims forms for email, postal or fax lodgement
Liability Claim form
984 KB,
pdf
Liability - Property Damage Claims Email: pdl.claims@zurich.com.au
Liability - Bodily Injury Claims Email: liability.claims@zurich.com.au
Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059
Fax: 1800 284 929
Call 132 687
New fast-track settlement service for eligible liability claims.
Less complex, low value claims are now fast-tracked by a specialist team. When all the supporting documents are provided along with bank account details, we aim to process these eligible claims within 5 business days.
Emergency Travel Assist: +61 2 8907 5671
Claim forms for email or postal lodgement
Business Travel Insurance Claim form
565 KB,
pdf
Corporate Travel Insurance Claim Form
709 KB,
pdf
Email: ah.claims@zurich.com.au
Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059
Call 132 687
Professional Indemnity, Directors and Officers, Employment Practices, Management Liability
Financial Lines Claims can be made under any products such as Directors and Officers Liability, Councillors and Officers Liability, Professional Indemnity, Crime and Employment Practices Liability. The range of claims that can occur is very broad. To assist you in making a claim under a Financial Lines Product we have developed a range of Claim Forms and Guidelines which can assist.
Claim forms for email or postal lodgement
Professional Indemnity Insurance Claim Form
908 KB,
pdf
Employment Practices Liability Claim Form
847 KB,
pdf
Email: fl.claims@zurich.com.au
Post: The Claims Manager, Financial Lines Claims, PO Box 677, North Sydney NSW 2059
Call 132 687
Guidelines
Commercial Crime Insurance Reporting Guidelines
593 KB,
pdf
Claim forms for email, postal or fax lodgement
Golf - Legal Liability Claim form
599 KB,
pdf
Golf - Sporting Equipment Claim form
692 KB,
pdf
Liability - Property Damage Only Email: pdl.claims@zurich.com.au
Liability Email: liability.claims@zurich.com.au
Post: Zurich Financial Services, Locked Bag 2138, North Sydney NSW 2059
Fax: 1800 284 929
Call 132 687
Track your claim
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When it comes to claims, Zurich delivers
Zurich’s claims team is dedicated to helping customers get back to business promptly, and has the credentials to show for it, including:
- An average 4.5 stars out of 5 claims rating (claimscomparison.com)
- Australian General Insurer Claims Team of the Year (2019 Insurance Business Awards)
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