About You

Name(Required)

Full Name

Phone(Required)

Email(Required)

Business Name

ABN

Address(Required)

State Post Code

Referral

Insurance Types You Are Interested In(Required)

What Trade & Contractor Insurances would you like to cover?(Required)

Public Liability

General Property (inc. Tools)

Personal Accident & Sickness

Builders & Contract Works

Work Vehicle Insurance

Insurance History

Are you currently insured?(Required)

Yes

No

Current / Previous Insurer

Expiry Date

Have you had any claims, convictions or bankruptcy??(Required)

Yes

No

Please provide details of prior claims, convictions, or bankruptcy

Truck Insurance

Overnight Parking Address

Postcode

What do you transport?

Truck Count(Required)

Single Truck

Multiple Trucks

Year, Make, Model(Required)

Rego

Sum Insured

Age of Main Driver

How many trucks do you have in your fleet?(Required)

Commercial Property Insurance

Property Address to be Insured

Postcode

Number of Tenants

Tenant Occupation(s)

Annual rental amount or estimated turnover

When was the building first built?

Buildings Sum Insured

Motor Trades Insurance

Industry Description (e.g. mechanic shop, mobile mechanic, tyre shop, etc.)

Property Address

Postcode

Estimated Annual Revenue / Turnover

What insurance covers would you like us to include in your quote?(Required)

Public & Product Liability

Business Property (Building, Contents, Stock)

Theft or Burglary

Business Interruption

Machinery Breakdown

General Property (Tools)

Glass

Commercial Motor

Unsure – I’d like some guidance

Plant and Machinery

Equipment Description (Year, Make, Model)(Required)

Occupation(Required)

Normal Parking Address

Sum Insured(Required)

Public Liability Insurance

Tell us about your public liability insurance needs

Trades and Construction Insurance

Full Occupation and activities(Required)

Other Occupation(Required)

Detail of Activities(Required)

Public Liability Information

Select your Liability cover limit(Required)

$10,000,000

$20,000,000

Estimated Business turnover(Required)

Estimated payments to contractors

Estimated payments to Labour Hire

No. of employees and directors (including yourself)(Required)

Employment status of employees(Required)

Maximum height you work at

Do you work airside?

Yes

No

Do you do any work involving swimming pools?

Yes

No

General Property Information

Total sum insured for required for full replacement(Required)

Any single items over $2,000 individually?

Item Description	Sum insured (value)	Actions

There are no Insured Items.

Personal Accident & Sickness Insurance

Date of birth(Required)

Your taxable income over the past 12 months(Required)

Gross Weekly Benefits

Enter a figure you wish to insure for. This can be anywhere up to your taxable income over the last 12 months after business expenses.

Weekly Accident Benefit

Weekly Sickness Benefit

Benefit Period(Required)

52 Weeks

104 Weeks

Permanent Disability/Death Benefit

Enter a figure you wish to insure for in the event you became Permanent Disabled or Passed Away

Capital Benefit Sum insured

Landlord Insurance

Address

DOB of oldest insured person

Required Start Date

When was the building was first constructed?

Occupancy Type

Property type

Roof Construction (Colorbond, Tiles, Concrete etc)

External wall construction

Built on

Number of Storeys

Number of Bedrooms

Number of Bathrooms

Buildings Sum Insured

Contents Sum Insured (any curtains, carpets, blinds, white goods)

Rental Amount Per Week (approximately is fine)

What type of security exists on accessible doors (deadlocks, security doors, key card access)

What type of security exists on accessible windows (security screens, key operated)

What type of burglar alarm system

Home & Contents Insurance

DOB of oldest insured person

Required Start Date

Address

When was the building was first constructed?

Property type

Roof Construction

External wall construction

Built on

Number of Storeys

Number of Bathrooms

Number of Bedrooms

Buildings Sum Insured

Contents Sum Insured (any curtains, carpets, blinds, white goods)

What type of security exists on accessible doors (deadlocks, security doors, key card access)

What type of security exists on accessible windows (security screens, key operated)

What type of burglar alarm system

Travel Insurance

Tell us about your travel insurance needs

General Inquiry

Business Insurance

Farm Insurance

Tell us about your insurance needs

Refer a client

Our Details

Business Info

COMPLIANCE DOCS

Get in Touch

About You

Insurance History

Truck Insurance

Commercial Property Insurance

Cafe, Restaurant & Hospitality Insurance

Motor Trades Insurance

Plant and Machinery

Public Liability Insurance

Trades and Construction Insurance

Public Liability Information

General Property Information

Personal Accident & Sickness Insurance

Gross Weekly Benefits

Permanent Disability/Death Benefit

Landlord Insurance

Home & Contents Insurance

Travel Insurance

General Inquiry

Business Insurance

Farm Insurance

Refer a client

Our Details

Business Info

COMPLIANCE DOCS

Get in Touch

LET’S GET YOUCOVERED!

About You

Insurance History

Truck Insurance

Commercial Property Insurance

Cafe, Restaurant & Hospitality Insurance

Motor Trades Insurance

Plant and Machinery

Public Liability Insurance

Trades and Construction Insurance

Public Liability Information

General Property Information

Personal Accident & Sickness Insurance

Gross Weekly Benefits

Permanent Disability/Death Benefit

Landlord Insurance

Home & Contents Insurance

Travel Insurance

General Inquiry

Business Insurance

Farm Insurance

LET’S START YOUR CLAIM!

LET’S GET YOUCOVERED!