Request for Compensation Form

Request for Compensation Form(PDF, 793KB)

This form should be completed and forwarded to:

Echelon Claims Services
GPO Box 1229
MELBOURNE VIC 3001

or via email: claimsadmin@echelonaustralia.com.au.

For any queries on the completion of this form: Please contact Echelon Claims Services on Ph: (03) 9860 3449 or via email: claimsadmin@echelonaustralia.com.au.