Brand

Home & Contents Insurance

What is the address of the property you would like to insure?

Please select your address from the dropdown menu.
Please enter your address.

Does the property have an alarm?

Please select an option.
Yes
No

Is the alarm monitored by a third party / security company?

Please select an option.
Yes
No

Is the home used for business?

Please select an option.
Yes
No

Who lives in the home?

Please select an option.
  • Owner Occupied
  • Rental

What year was the home built?

If your home was built before 1945 we'll be in touch with an additional questionnaire.
Please enter a year.

How many levels in the home?

Please enter a number.

How many square metres is the home?

Please enter a number.

Does the home have a garage?

Please select an option.
Yes
No

How many square metres is the garage?

Please enter a number.

Does the home have a deck?

Please select an option.
Yes
No

How many square metres is the deck?

Please enter a number.

Does the home have a pool?

Please select an option.
Yes
No

How many square metres is the pool?

Please enter a number.

Does the home have an outbuilding?

A smaller separate building such as a shed or barn that belongs to the home.
Please select an option.
Yes
No

How many square metres is the outbuilding?

Please enter a number.

Total square metres?

Please enter a number.

Total sum insured for the Home?

The sum insured is the maximum amount your insurance company will pay in the event that your home is totally destroyed or badly damaged.
Please enter a number.

Does the home have any self contained units?

Self contained means kitchen and bathroom facilities.
Please select an option.
Yes
No

How many self-contained units does the home have?

Please enter a number.

Please note any financial interests (if any).

Generally this will be the Mortgage Lender.

Does this home have existing home insurance?

Please select an option.
Yes
No

What is the current excess?

Please enter an amount.

Who is the current insurer?

Please let us know the insurance company.

What is the current premium?

Please let us know the insurance company.

Has there been any claims on the home in the last 5 years?

Please select an option.
Yes
No

Please supply details of each claim.

Please include the date (month and year is fine), what the claim was for and how much this cost to repair, replace or fix.

Have you ever been declined home insurance?

Please select an option.
Yes
No

Please supply details.

Is water to the home supplied by municipality?

Please select an option.
Yes
No

Total sum insured for your contents?

Please enter a number.

Does you have existing contents insurance?

Please select an option.
Yes
No

What is the current excess?

Please enter an amount.

Who is the current insurer?

Please let us know the insurance company.

What is the current premium?

Please let us know the insurance company.

Do you have any jewellery, camera's or photographic equipment worth over $3,000?

Please select an option.
Yes
No

Please list your jewellery, camera's or photographic equipment below.

Please enter some details.

Do you have any laptops or cell phones that are used for business?

Please select an option.
Yes
No

Please list all your business laptops or phones below.

Please enter some details.

Have you had any contents claims in the last 5 years?

Please select an option.
Yes
No

Please include details below.

Please enter some details.
Please include the date (month and year is fine), what the claim was for and how much this cost to repair, replace or fix.

Have you had been denied contents insurance?

Please select an option.
Yes
No

Please include details below.

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Date of Birth

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