Before we start

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  • Reference numberYou'll find this in the letter we have sent for the amount owed to us.

You may also need

  • Income detailsDetails of your employment and income
  • Expenses & liability detailsDetails of your living expenses, loans, credit cards, etc.
  • Asset detailsDetails of your properties, vehicles, savings, superannuation, etc.

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about 5 - 15 mins

By continuing, you confirm that you have accessed and read the RACQ Privacy Policy which contains information on how RACQ collect use and disclose your personal information.

Payment Reference number

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Not sure where to find your payment reference number?

 

Your payment reference number can be found in the bottom right of your payment form. Some forms may also have it repeated in the top right.

 

Still don't have a payment reference number?

 

Please contact Insurance Claims on 13 7202

Your details - {{data.claimNumber}}

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Your name
Your date of birth
Block (Mandatory)
Home address
or, alternatively,

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Manually enter an address

Address
Is this application for a company or business?

How would you like us to reach you?

What is your preferred contact method?
What is your preferred contact method?

Enter your contact details below and select the best option for us if we need to get in touch with you. We'll use your preferred contact method, but may need to call you to discuss the application over the phone.

Should we need to contact you to discuss your application, please select a preferred contact time.

Would you like to nominate a representative for this application?
Postal address
or, alternatively,

Continue typing...

Manually enter an address

Address

Your nominated representatives details

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Name
Are they a company or business?

How would you like us to reach them?

What is their preferred contact method?
What is their preferred contact method?

Enter their contact details below and select the best option for us if we need to get in touch with them. We'll use the preferred contact method indicated, but may need to call to discuss the application with them over the phone.

To authorise your nominated representative, please either:

  •  Call us on 137 202
  •  Send an Email to claims@racq.com.au, with your claim number in the request
  •  Attach your authorisation now

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Your situation

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How many dependents do you have?
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Age of dependent {{data.$i +1}}

Additional support

Do you require any additional support due to the following? Please select all that apply.
Thank you for sharing your circumstances with us.

Your employment

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Your income

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Income
Income

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Current income
Assets
Asset

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Your expenses

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Your living expenses

Mortgage / rent / board
Car finance repayments
Loan repayments
Credit card repayments
Child maintenance
Groceries
Fares / petrol
School fees
Hospital / medical costs
Insurance / superannuation
Rates / water
Gas / power
Phone / internet
Vehicle registration
Other income

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How long is left to pay off the loan?
Block (Mandatory)
Will you cancel this card if this application is approved?
Expense amount

Other expenses

Please add any other expenses you have. Include other expenses such as rent-try-buy contracts, which you may not have included in the expenses section above.
Are there any other adults in the household that contribute to expenses?
Do you have any other hardship applications with other credit providers?

Your financial history

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Do you intend to declare bankruptcy?
Is any Government Agency, court ruling or financial institution pursuing you for another debt?
Are you seeking alternatives to alleviate your financial situation such as release of superannuation, etc.?

Review your application before submitting

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Your details
Claim number
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Name
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Date of birth
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Home address
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Postal address
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Mobile number
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Email address
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Nominated representatives details
Name
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Company or business name
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Mobile number
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Email address
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Financial summary

This is based on what you have told us your income and expenses are.

Net Income:
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Expenses
Your expenses:
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Expense contributed by others:
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Net expense:
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Amount remaining:
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Hardship application summary
Current employment
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Employment situation
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Vulnerability support
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Review application

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Is more information required?
What documents are required?
Will the applicant provide the requested information by mail?

A quick request for more information

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OR

Review requested information

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Has the financial hardship task been manually created in ClaimCenter?
Has the document/requested information received?

Complete application

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Has the claim updated in ClaimCenter?