Apply Online

The fastest way to get into a free rental car is to apply online. Simply fill out as much of the information below as you can. If you don’t know something at this time you can enter ‘unknown’.
And you can always call us on 1300 789 960.

PARTY NOT AT FAULT (i.e. You)

Your First and Last Name (required)

Address and Suburb

Your Mobile Number (required)

Your Email (required)

Are you the owner of the vehicle?

YesNoUnsure

Your Vehicle Details

Your Rego (required)

Make and Model

Your Insurance Details

Insurance Company

Claim number

PARTY AT FAULT

First and Last Name (required)

Address and Suburb

Mobile Number (required)

Party at Fault Vehicle Details

Party at fault Rego (required)

Make and Model

Party at Fault Insurance Details

Insurance Company

Claim number

ACCIDENT DETAILS

Date of accident

Street Address and Suburb

Number of cars involved

Accident description