Home Insurance

Contact Details


  

  

  

  

  

 

 
   

Insured Details

 
 

 

  

  


  

  


  
Current Insurance expiry:

  


 
     

Insured Details

   
  Insured 1 Insured 2
First Name
Surname
Date of Birth
Pensioner
   

 Period of Insurance 

 
From:  

To:  

Insurance History

 
 
In the last 5 years have you had any:  




  

  
   

Risk Details

   
Details Location 1 Location 2
Address
Type of Building
Block Size
How Occupied
     
Construction    
Walls 
 
Floors
 
 
Roof
 
 
Year Built 
 
 
Renovated or Rewired 
 
 
Size m/squares 
 
 
     
Security/Safety    
Describe Door Locks
 
 
Describe Window Locks
 
 
Describe Alarm System 
 
 
Any Fire Safety Equipment 
 
 
     
Other Risk Factors    

Under renovations,construction or needs repair

 
Heritage Listed
 
Strata titled
 
Swimming Pool or External Spa
 
Will the home be unoccupied for longer than 60 days
 
Flood Cover
 
Power Surge
 

Fusion to Electric Motors
(Fridge, Air conditioner etc)

 
Spoilage to food after fusion
 
 
Replacement locks and keys
 
Death or Vet cover for pets
 
Personal tax audit costs
 
Accidental damage or defined events
 
 
Are landlords fixtures and fittings to be covered under building sum insured
 
 
Is malicious damage by tenants required
 
 
Does a business operate from premises, describe
 
 
If you have answered yes to the above, please provide details of the buisness
     

Other Locations

   
If you have 2 or less locations please skip to Home Building section   
Details Location 3  Location 4
Address
 
Type of Building
 
 
Block Size
 
 
How Occupied 
 
 
     
Construction     
Walls
 
Floors
 
 
Roof
Year home built
 
 
Renovated or Rewired
Size m2 / squares
     
Security/ Safety    
Describe Door Locks
Describe Window Locks
Describe Alarm System
Any Fire Safety Equipment
     
Other Risk factors    
Under renovations, construction or need repairs
Heritage Listed
Strata Titled
Swimming Pool or External Spa
Will the home be unoccupied longer than 60 days
Flood Cover
Power Surge
Fusion to Electric Motors (E.g Fridge, Air conditioner)
Spoilage of food after fusion
Replacement locks and keys
Death or Vet cover for pets
Personal tax audit costs
Accidental damage or defined events
Are landlords fixtures and fittings to be covered under building sum insured
Is Malicious damage by tenant required
Does a buisness operate from premises
If you have answered yes to the above, please provide details of the buisness
 
     

Home Building

   
 Location Sum Insured  
Location 1
 
Location 2
 
Location 3
 
Location 4
 
 
     

Contents

   
Unspecified Contents    
Location 1
 
Location 2
 
Location 3
 
 
Location 4
 
 
     
Specified Contents    
Typically contents valued over $3000, or special items should be specified
*Please provide details of item and location where item is located
 
Item Sum Insured  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     

Specified Personal Valuables

   
Cover required
 
Unspecified Items Total sum insured
 
Limit any item
 
     
Item Sum Insured  
 
 
 
 
 
 
 
 
 
 
 
     

Loss of rent & rent default

   
Cover required
 
 
Weekly Rent ($)