Involuntary unemployment claim form

In addition to filling out the below form, you must also provide as attachments in Section B;

  1. A letter from your employer confirming the date your employment ceased or you were stood down, including the reason why.
  2. Your last 4 pay slips prior to your employment ceasing or stand down.

We appreciate that everyone’s employment circumstances are unique. If you think you cannot source or provide the above, please continue to complete the below form and our claims team will discuss alternate options with you once submitted.

Section A - Your details

Required fields marked with an asterisk (*)

Please combine your area code and phone number. For example, 0212345678.

Please do not put spaces between the numbers.

Please do not put spaces between the numbers.

Section B - Your involuntary unemployment details

Letter from employer

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Section C - Declaration and authorisation

I declare that:

1. the above information is true and correct and I have not withheld any relevant information. I shall also agree to supply any further information as requested by QBE.

2. I authorise Centrelink or any person or firm who has employed me to release any information sought on this claim form to QBE.

3. I acknowledge that payments are calculated to the date the unemployment certificates are stamped and signed by Centrelink.

4. I consent to QBE disclosing my personal information to and/or collecting additional information about me from investigations or legal advisors.

Please print your full name.

This field is required.


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