• Cover 4 Insurance Claims Services

    Contact Us: 0161 974 1101

  • Policy Details

  • ( If your university is not on the list please revisit the main website for contact information )
  • Policy Holder Details

  • INSURED ADDRESS (For Example, Term Time Address)

  • HOME ADDRESS (IF DIFFERENT)- add heading

  • DETAILS OF YOUR CLAIM

  • :
  • :
  • NAME(S) OF OTHER RESIDENT(S)DID THEY SUFFER A LOSS? YES/NOAMOUNTARE THEY INSURED SEPARATELY?IF YES, PLEASE PROVIDE THE INSURER NAME 
    Add a new row Remove this row
  • PLEASE PROVIDE FULL DETAILS OF THE CIRCUMSTANCES LEADING UP TO AND SURROUNDING THE INCIDENT, AND ITS DISCOVERY
  • DETAILS OF POLICE SECURITY REPORT

    BEFORE SUBMITTING THIS FORM, PLEASE ENSURE THAT ALL THEFT OR MALICIOUS DAMAGE CLAIMS ARE REPORTED TO THE POLICE.
  • :
  • DESCRIPTION OF ITEMSMAKE, MODEL & SERIAL NUMBERDATE OF PURCHASEWHERE PURCHASED OR FROM WHOM?ORIGINAL COST PRICECURRENT COST PRICE 
    Add a new row Remove this row
  • TOTAL AMOUNT CLAIMED
  • CLAIMANT DECLARATION

    • I DECLARE THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
    • I UNDERSTAND THAT ANY MISSTATEMENTS OR WITHOLDING OF INFORMATION WILL RENDER MY CLAIM VOID AND MAY LEAD TO CRIMINAL PROCEEDINGS AGAINST ME.
    • I HAVE NOT WITHELD ANY INFORMATION CONNECTED WITH THIS INCIDENT AND AGREE TO PROVIDE ANY FURTHER INFORMATION OR DOCUMENTATION AS MAY BE REQUIRED.
    • I AGREE THAT THE INSURER SHALL HAVE ABSOLUTE DISCRETION IN THE CONDUCT OF ANY PROCEEDINGS OR SETTLEMENTS OF ANY CLAIMS AGAINST ME ARISING OUT OF THIS INCIDENT
    • I UNDERSTAND THAT THE INSURER DOES NOT ADMIT ANY LIABILITY BY THE ISSUE OF THIS FORM
  • WHAT TO DO NEXT

  • Please attach your Policy Schedule and/or Master Policy Schedule (if applicable) and any supporting documentation in the Document Upload section.

    IMPORTANT: PLEASE ENSURE THAT YOU INCLUDE ANY PROOF OF PURCHASE / OWNERSHIP DOCUMENTATION (SUCH AS PURCHASE RECEIPTS, GUARANTEE CERTIFICATES, INVOICES ETC…. ), FOR ANY ITEMS BEING CLAIMED FOR WHERE POSSIBLE.

  • DOCUMENT UPLOAD

  • Drop files here or
  • DATA PROTECTION MANDATE

  • I hereby consent to my student accommodation provider sharing any of my relevant data in connection with my insurance claim to Stream Claims Services on behalf of Claims Consortium Group, who will use the information only for the purposes of the assessment of the insurance claim referenced above. I also acknowledge that without this information, Stream Claims Services will be unable to progress my claim

  • CLAIMS HELPLINE: 0161 974 1101