Windscreen Insurance Claim Form

Submit your claim

Page: Claims - Windscreen

"*" indicates required fields

Insured Name*

Email*

Phone*

Policy number*

Insurance Product*

Make and model of the vehicle*

Vehicle year of manufacture*

Vehicle registration number*

Date of breakage*

Accident location: street, suburb, post code*

What was the type of glass damaged?*

Additional Information (optional)

Do you have a supporting quote, invoices or photo’s that will assist us to lodge your claim with your insurer? (If yes – please email these to claims@bruce.com.au).

This field is for validation purposes and should be left unchanged.