Register CBA CCI

Personal Info

Name*

First Name

Last Name

Email*

Confirm Email *

Contact number*

Please include international and state area codes

Date of birth*

Address

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Please select the CCI policies you were sold:

CBA Credit Card Plus CBA Personal Loan Protection

Note: CCI refers to "consumer credit insurance". This information is stated in the notice you may have recently received.

What is the date your first CBA CreditCard Plus CCI policy was purchased?

Note: To be eligible, policies must have been purchased between 1 January 2010 and 7 March 2018. This information is stated in the notice you may have recently received.

What is the date your first CBA Personal Loan Protection CCI policy was purchased?

Note: To be eligible, policies must have been purchased between 1 January 2010 and 7 March 2018. This information is stated in the notice you may have recently received.

Please select what types of cover you held on your CBA Personal Loan Protection policy (Tick all options that apply if more than one type of cover was held)

Loan Repayment Cover Loan Cover Not sure

Please select which (if any) CCI policy you were sold has been cancelled:

CBA CreditCard Plus CBA Personal Loan Protection

Note: CCI refers to "consumer credit insurance". This information is stated in the notice you may have recently received.

Do you recall how you were sold a CCI policy?

Yes No

Please provide us with a description of what you remember about being sold a CCI policy:

Note: If you held several CCI policies and there were different circumstances relating to your eligibility at the time of being issued those policies, please elaborate here.

Do you recall how you were sold a CCI policy? (Tick all options that apply if you were sold more than one type of CCI policy)

In a CBA branch Over the telephone Online Do not recall

You have indicated that you do not recall being sold a CCI policy. Please describe how you become aware that you had in fact purchased the CCI policy:

Note: If you held several CCI policies and there were different circumstances relating to your eligibility at the time of being issued those policies, please elaborate here.

During the period you had a CCI policy did you experience financial hardship, such as reduced work hours or marital breakdown?

Yes No

Did you receive financial hardship support from CBA at that time?

Yes No

Have you ever tried to make a claim on a CCI policy?

Yes No

Please provide us with more information, such as why you made a claim, and what happened after you made the claim:

Note: If you had tried to make multiple claims, or held several CCI policies and had tried to make a claim on either of the policies, please elaborate here.

Tell us your story (optional):

Note: Please tell us anything else about you and your experience with being sold a CCI policy or making a claim on that insurance. If you held several CCI policies and there were different circumstances relating to your eligibility at the time of being issued those policies, please elaborate here.

Do you have life insurance, income protection insurance, or TPD insurance? (Please tick all that apply. If none apply, do not check any boxes)

Yes, life insurance Yes, income protection insurance Yes, TPD insurance Not sure

Have you received any refund or any remediation from CBA for the premiums you paid for your CCI policy?

Yes No Not sure

Note: You may still be an eligible group member if you have not been refunded in full for the premium paid for our CCI policy or have not successfully claimed more than the premium paid amount.

Tell us about your remediation from CBA (optional):

*

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