Car Insurance

Whether you need new insurance or just want to compare your existing policy. Free Car Insurance quotes are avaliable with Ausure, please complete the form below, and click submit. One of our friendly Brokers will contact you shortly if you only complete the required fields. Fields marked with * are mandatory. Please complete the full form if you would like a Broker to quote your insurance and contact you with prices.

CarID:
First Name::
Last Name::
Phone with Area Code*::
Mobile Phone*::
Email Address*::
Legal Name::
Trading Name::
ABN (if applicable:
ACN (if applicable):
Street Address*::
Suburb*::
Postcode::
Date of Birth::
Pensioner:
From::
To::
Had a proposal or renewal declined or special tersm imposed::
Been Charged or Convicted of a Criminal Offence:
Have you had any claims:
Are there any other factors that may affect an insurer's assessment:
If you have answered YES to any of the above questions, please provide details here::
Current Insurer, or type not insured::
Cover Required:
Year::
Make::
Model::
Body Type::
Please provide details if 'Other' selected as Body Type::
Registration Number::
VIN/Engine Number::
Engine Size::
Engine Details::
Transmission::
Carrying Capacity (Goods Carrying Vehicles Only)::
Non-Standard Modifications (Performance enhancing or more attraction to thieves including but not limited to Mag Wheels, Special Paint, Body Kits and Special Stereos)::
Non-Standard Accessories (Optional extras from dealer not factor fitted - e.g. Window Tinting, Allow Wheels, Spoiler, Air Conditioning, Tow Bar, Weather Shield, Bug Guards)::
Usage:
How is the Vehicle Garaged?::
If you have selected 'Other' above, Please provide details::
If your vehicle is garaged, please provide address::
Registered Name::
Estimated Current Value::
Sum Insurered::
Type of Finance::
Financed By::
Address of Financer::
Security::
Optional Extensions::
Driver 1: Name::
Driver 1: Date of Birth::
Driver 1: Years Licenced::
Driver 1: Are you entitled to No Claim Bonus?::
Driver 1: Sex::
Driver 1: Have you had any accidents in the last 5 years?::
Driver 1: In the last 5 years have you had any claims::
Driver 1: If you have answered 'YES' to any of the above questions, Please provide details::
Driver 2: Name::
Driver 2: Date of Birth::
Driver 2: Number of years licenced?::
Driver 2: Are you entitled to No Claim Bonus?::
Driver 2: Sex::
Driver 2: Have you had any accidents in the last 5 years?::
Driver 2: In the last 5 years have you had any claims?::
If you have answered yes to any of the above questions,please provide details here::
Would you like Restricted/Nominated Driver Policy?::
Would you like more than 2 drivers listed on the policy::
Is cover required for any under 25 year old undeclared drivers?::
If yes, do they own their own car?::