Policy Amendment Request Form (effective from 16 Aug 2021)

THIS FORM IS TO BE COMPLETED WITHIN 24 HOURS OF AN ISSUE OCCURRING OR BEING IDENTIFIED.

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These issues include but not limited to:

Agent did not issue policy same (or next) business day as receipt of payment

Incorrect policy details

Existing Medical Condition assessment

Policy excess error

Duplicate policy issued

Agent did not cancel a policy

Agent did not extend a policy

Agent cancelled the policy without client consent

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Refer to the "Policy Amendment Request Guide" attached to this form for guidance on completing this form.

PLEASE NOTE your request cannot be processed unless all required proof documents are attached on this form (in "Evidence Documents" section at the bottom) before you submit.

For any questions or queries you have, please contact our Customer Service Team on 1300 72 88 22.