Claim notification service

This form notifies us of your intent to make a claim as a result of an illness or injury. We will contact you to complete the claim lodgement
We understand that making a claim comes at a challenging time for you and your family. We will do our best to make sure that all of your contact with us is handled in a timely, professional and caring manner.

Fields marked with * are mandatory

Date of Birth

(DD/MM/YYYY)

Your preferred contact number

Your preferred email address

Benefit type

You can find out what benefits you’re entitled to by checking your annual statement, logging into My Resolution Life, or talking to your financial adviser.

Directly from Resolution Life

Superannuation arrangements

Your adviser details

If you have a adviser and would like us to contact your adviser directly about this claim, please provide their details below.

Your adviser's contact number

My Injury / Illness will prevent me from ever returning to work

My Injury / Illness currently prevents me from going to work, but I expect to work in the future

I have a terminal illness

I have a condition listed under my crisis / trauma plan

I am claiming on behalf of a policy owner who has passed away

I am claiming on behalf of a policy holder

Please describe the illness, injury or condition to which this claim relates.

For more details about privacy and the information we collect, please read our Privacy Collection Statement

Claim notification service

Your policy details

Your adviser details

About your claim