Current Clients

Santam Personal Multiplex
Policy Wording
At Gary Leech, we believe that you should have a positive claims experience with a speedy turnaround time, and we want the process to be as easy and stress-free for you as possible. 

If you need to register a claim, you can do so by downloading the required form and following the instructions below:

Online - Print and complete the relevant claim form, scan it in and submit it to us here...

Name*
Claim Form Upload*

Fax - Print and complete your claim form and return it to us by fax 086 613 7455.

There are four standard claim forms that you can download from our web site. Please select the relevant claim form and follow the instructions as detailed.

(NB! To download these forms you need a PDF reader. Click to download Adobe® Acrobat from the Adobe web site)

IN ORDER TO MEET POLICY CONDITIONS THE CLAIM FORM
MUST BE RECEIVED WITHIN 30 DAYS OF THE LOSS


Download motor accident claim formMOTOR ACCIDENT CLAIM FORM - This is for motor vehicle accidents/break-ins (without vehicle being stolen).

Download motor accident claim form

Procedure/Requirements:
  • Contact our office & report claim.
  • Forward Claim Form & a copy of the drivers licence within 30 days of the loss.
  • Our representative will discuss the assessment & quotation arrangements.
  • Report to nearest office of the S.A.P. and obtain case Ref No.
  • Do not admit responsibility to a third party, merely state "the matter will be reported to our insurers immediately".
  • At the time of accident, try to obtain a statement from an onlooker outside of the vehicle or vehicles involved.


Download motor theft claim formTHEFT OF MOTOR VEHICLE CLAIM FORM - This is completed if your vehicle has been stolen.

Download motor theft claim form

Procedure/Requirements:
  • Contact our office & report claim.
  • Provide us with completed Claim Form within 30 days of the loss.
  • Determine whether you have "vehicle hire" cover.
  • Report to nearest office of the S.A.P.
  • Keys, remotes, including spares to be submitted to ourselves.
  • Original ownership registration certificate to be submitted (If vehicle on finance, obtain this document from finance co.)
  • Letter from finance company stating cash settlement figure.
  • A copy of last service invoice.
  • Documents to support non-factory fitted accessories.
  • Expected period of settlement - two (2) weeks after receipt of all documentation.


Download non-vehicle claim formNON-MOTOR CLAIM FORM FOR CLAIMS UNDER R5000 - This is completed for the theft of or damage to any items other than a motor vehicle where the total claimed value does not exceed R5000.

Download non-vehicle claim form

Procedure/Requirements:
  • Contact our office & report claim.
  • Provide us with completed Claim Form within 30 days of the loss.
  • Supporting documents that substantiates cause of damage, enables quicker processing.
  • These claims should be settled within one (1) week.


Download property loss claims formPROPERTY LOSS CLAIM FORM - This is completed for the theft of or damage to any items other than a motor vehicle where the total claimed value exceeds R5000.

Download property loss claims form

Procedure/Requirements:
  • Contact our office & report claim.
  • Provide us with completed Claim Form within 30 days of the loss.
  • Report to S.A.P. if a theft has occurred.
Note: In order to view the downloadable claim forms, you must have Adobe® Acrobat version 5.0 or above. Click to download Adobe® Acrobat from the Adobe web site.


Additional Downloads

Risk Questionnaire
Inventory Form
Brokers Mandate
Kathy Petherbridge Disclosure
Gary Leech Disclosure
Debit Order Authority