CLAIM FORM

Please follow the instructions in this document to submit your claim.

In terms of your policy you must notify Santa Fe of any potential claim within thirty (30) days of delivery. Your notification must include a list of any damages/ losses you wish to claim for.

Thereafter you must submit your fully documented claim within forty five (45) days from the date of notification.

Inspect goods immediately. Under no circumstances, except under written protest, give a clean receipt to carriers where the goods are in doubtful condition.

All items should be unpacked at time of delivery. Claims for loss or damage for self-unpacked items will be not considered.

Exercise utmost care to minimise loss or damage discovered and avert further loss or damage.

You must not dispose of any damaged items unless confirmed in writing by Santa Fe.

Please complete your claim form in as much detail as possible; this will help speed up the processing time for your claim.

If you require assistance in obtaining repair estimates please make this clear when submitting your claim form.

Complete the bank remittance details, upon settlement of your claim you will be asked to reconfirm these.

Select the currency you wish to receive settlement in. Please note that claim payments will only be made in Euro’s, British Pounds, Swiss Francs or United States Dollars.

Before signing and returning your form please ensure you have documented all items you wish to claim for as additional items/ claims will not be considered once your claim has been submitted.

Sign and date your completed claim form and attach your supporting documents.

Your claim should then be returned to Santa Fe.

Once you have submitted your completed claim form to Santa Fe your claim will be forwarded to the relevant department for assessment.

Please note that for claims where there are missing items insurers may require a police report. If you are required to provide a police report you will be instructed of this accordingly.

Underwriters reserve the right to appoint loss adjusters. If a loss adjuster is to be appointed insurers shall advise you of this on receipt of your completed claim form.

Underwriters are unable to cover the cost of any charges levied by your bank for receiving payments.

Please ensure that the beneficiary bank account noted on the claim form is the bank account of the policy holder i.e. the named person on the insurance certificate.

The following must be submitted with your claim form:

For damaged items

Colour photographs of the damaged item. Please ensure that the photographs show the damage and also the entire item as a whole.

Submission of proposed repair costs (repair quotes etc.) where appropriate. Please notify Santa Fe if you require assistance in providing repair estimates.

Third party replacement costs. E.g. the original purchase receipt if available; a web-link from the internet providing it shows the item to be replaced.

For lost or missing items

Third party replacement quotations can be obtained over the internet for items that are the same or similar in kind and quality to what was damaged. Once you locate a comparable item, please be sure that the page includes the item description/features, picture, price and website information.

*Claims cannot be settled without supporting documentation

Before submitting your claim form please ensure the following:

ü  The ‘Your Details’ section is completed

ü  You have listed all items you wish to claim for noting the damages/ losses

ü  You have provided your account details and indicated the currency you wish any settlements to be made in

ü  You have signed and dated your claim form.

ü  You have enclosed supporting documentation

Please submit your claim to Santa Fe.

Name
Address
Email Address
Telephone Number
Date of Delivery
Description on Insurance Valuation Form / Category / Room where Insured / Insured Value / Description of Loss or Damage / Repair / Replacement Cost
Currency
/
Total Claimed Amount
/
Account Holder Name
Account Number
Bank Name
Bank Address
Bank Sort Code
SWIFT/ BIC Code
IBAN Number

Please indicate the currency you wish to receive settlement in

United States Dollars
Euros
Great British Pounds
Swiss Francs

I declare that all claim information I have submitted is true and accurate.

Signed: Date:

Claims are Administered by Pac Global Insurance Brokerage Inc.