Complete the form below to load your CCI claim with Motorlife

Select

PLEASE NOTE - For ACCIDENT and ILLNESS claims, you will need to upload your completed Medical Report. For REDUNDANCY claims, you will need to upload your Notice of Redundancy and letter from WINZ that you are seeking employment.

Full Name

Address

Phone

Your age on your next birthday

Occupation

Date

For ACCIDENT Claims - what injury have you suffered?

For ACCIDENT Claims

For ILLNESS Claims

For ILLNESS Claims - have you previously suffered from this illness?

YESNO

If YES please give details

For REDUNDANCY Claims

For PAYMENT PROTECTION Claims

If 'NO' where are they?

File upload

Click here to upload supporting documents for your claim

Declaration

I/We declare and/or understand:

All items in this claim form have been completed accurately. Failure to provide full and correct information could result in this claim not being accepted by Beneficial Insurance Limited ('BIL').

How do I make a Consumer Credit Indemnity (CCI) claim?

Call Motorlife

Required Information

Obtain Documentation

Claim Form

Quick Links