Household Appliances

"*" indicates required fields

1Your Details

2Claim Details

3Declaration

Your Details

Date of Incident*

The date the incident first occurred

DD slash MM slash YYYY

Policy Number*

The Unique Reference Number shown on your Policy Schedule

Customer Name*

First

Your First and Last Name as registered to the Policy or Warranty

Last

Address*

Address Line 1

The address to which your Policy or Warranty is registered

Address*

Address Line 2

The address to which your Policy or Warranty is registered

Address*

City

The address to which your Policy or Warranty is registered

Address*

Postcode

The address to which your Policy or Warranty is registered

Phone Number*

Telephone Number and Area Code

Email Address*

A current e mail address by which we can contact you

Claim Details

Product Purchase Date

The date you first purchased the product

DD slash MM slash YYYY

Product Purchase Price

The cost of the product at the time of purchase

Type of Appliance*

Fault With Appliance*

Please select from the dropdown list. Please also list any additional circumstances which you wish us to consider when processing your claim.

Manufacturer*

Manufacturer e.g. Bosch

Model/ Serial Number*

The Unique Model / Serial Number listed on the appliance or in the manual

Item Colour

The colour of the appliance

Integrated Appliance?

Is the item built into the units surrounding it?

Yes

Appliance Fuel Type

Gas

Electric

Both

Please provide an image of the appliance*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, docx, doc, Max. file size: 50 MB, Max. files: 8.

Please provide proof of purchase for the appliance*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, docx, doc, Max. file size: 50 MB, Max. files: 8.

Please provide an image of the rating plate if available

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, docx, doc, Max. file size: 50 MB, Max. files: 8.

Declaration

Is there any other information you wish to make us aware of?

Please check all your answers carefully before submitting your claim.

Declaration*

I hereby certify that all the information given in this form is truthful, accurate and complete.

CAPTCHA

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

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General Enquiry

Contact our customer services team via the contact us page

Sales Team

You can contact our sales team via the contact us page

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