Claim reconsideration form

Your energy Make a claim Claim reconsideration form

You can apply to have a claim reconsidered if you are not satisfied with the outcome. An officer who has not been involved in the original outcome will undertake the reconsideration of your claim. This is to ensure a fair and impartial reassessment. When the reconsideration is finalised, you will receive written advice for the outcome of the reconsideration and the reason for the decision.

It is important to indicate the basis upon why you believe the original claim decision was incorrect. Include any new and relevant information that may support your claim.

If you have any questions at any stage of the investigation, you can contact our claims team via email at claims@evoenergy.com.au.

Reconsider claim

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An applicant whose claim was not accepted or finalised to the satisfaction of the claimant, may apply to have their claim reconsidered. An officer who has not been involved in making the original decision will undertake the reconsideration of your claim. This is to ensure that you will receive a fair and impartial re-assessment of your claim. When the reconsideration is finalised you will receive written advice for the outcome of the reconsideration and the reason for the decision.

You can access and submit the Application for reconsideration form below. It is important that you indicate the basis upon which you believe the original claim decision was incorrect. Please also include any new information that may further support your claim and provide as much relevant information as possible, and attach extra notes if required.

*Denotes mandatory field

Your details

Given name *

Surname *

Daytime contact number *

Email address

Incident details

Reference number *

Date of incident *

Location of incident *

Claim details *

Reason for application

Please indicate the basis upon which you believe the original claim decision was incorrect. Please also include any new information that may further support your claim. Provide as much relevant information as possible, and attach extra notes if required. *

Upload extra notes (8 MB file upload size limit)

Attachment can be an Office document or PDF.

Statement

I / We acknowledge that:

All information provide, and statements made, are truthful and accurate and no information likely to affect the outcome of this claim has been withheld.
I/We acknowledge that Evoenergy will rely upon information supplied by me when determining this claim.
The property or goods, which are subject to this claim, are owned by me/us.
I have not made a claim for this damage to anyone else (including any insurers), nor will I make such a claim, if I accept any payment or other benefit from Evoenergy in the settlement of this claim.

I declare that the information contained in this application is correct.