Home and Contents Insurance Application Form

Thank you for requesting a quotation for your Home and Contents Insurance.  This application form will allow us to collect the necessary information to seek quotations on your behalf, and in some cases, there may be a requirement to provide additional information.

When completing this application form, it is important that you review your sums insured to ensure that they are adequate and reflect the movement in higher costs of replacement or repair.  In the event of a major loss, being under-insured can have substantial financial impacts on your ability to restore your property. We recommend you seek advice from a qualified professional to undertake a valuation for replacement cost of your property and improvements.

To assist with this, we have provided calculators on our website for both your building and your contents. This is not intended to replace a professional valuation but can assist as a guide CLICK HERE

NOTE: If you require insurance for your home and the building sum insured is in excess of $3,000,000, and/or your contents include high value items such as collections of artwork or jewellery, we may have more suitable products available to you. Please contact us directly at insurance@delphic.com.au  or by calling 1800 DELPHIC

 

Consistent with our commitment to transparency and as required by law, we are seeking your informed prior consent to receive commission in relation to the general insurance products we will recommend to you. 
 
The commission we will receive from the insurer(s) is included in the premium paid by you. It is part of our remuneration for the advice and ongoing support we provide in relation to your insurance needs, as set out in our Terms of Engagement.  For your understanding, the details of the Commission are as follows: 

Insurer	Annualised % of Base Premium	Frequency Paid
Insurer determined by outcome of marketing process	0 to 25%	Annually

If it’s in your interest, we may recommend that renewal of your policy is placed with an alternative insurer (you can find the list of alternative insurers with whom we may place your policy by visiting Insurer Partners or by asking us for a copy). Each of these insurers pay a rate within the band provided above. The name of the selected insurer and the exact dollar figure of the amount of commission we receive will be disclosed in our quotation document and/or tax invoice. 
 
Your Consent 
 
We ask for your consent to be paid by the relevant product provider the commission set out above.  Your consent is irrevocable and will apply to all new policies and future renewals, endorsements and variations of general insurance retail policies placed by us unless there is a material change in the rate of commission.  

Please answer all questions with a red asterisk, answers such as N/A may delay processing of this application.  Questions that are preceded with a † contain definitions of terms or explanations when you hover over them.  If you require any assistance, please contact us directly at insurance@delphic.com.au or call us on 1800 DELPHIC.

Is the property

- used for business purposes other than home office or surgery

- under construction, reconstruction or renovation

- in poor condition or poorly maintained

- currently unoccupied or expected to be unoccupied for more than 90 continuous days

  during the period of cover?

- under any heritage listing/National Trust listing or order

- used as a hostel, bed and breakfast or guesthouse

DUTY TO NOT MAKE A MISREPRESENTATION 
 
You have a duty under the Insurance Contracts Act 1984 (ICA) to take reasonable care not to make a misrepresentation to the insurer (your duty). Your duty applies only in respect of a policy that is a consumer insurance contract, which is a term defined in the ICA. Your duty applies before you enter into the policy, and also before you renew, extend, vary, or reinstate the policy. Before you do any of these things, you may be required to answer questions and the insurer will use the answers you provide in deciding whether to insure you, and anyone else to be insured under the policy, and on what terms. To ensure you meet your duty, your answers to all the questions must be truthful, accurate and complete. If you fail to meet your duty, the insurer may be able to cancel your contract, or reduce the amount it will pay if you make a claim, or both. If your failure is fraudulent, the insurer may be able to refuse to pay a claim and treat the contract as if it never existed. 

We draw your attention to the Important Notice accompanying this Application form. You must read the Important Notice carefully. If you do not understand the content of Important Notice, please contact us immediately.

If any of the statements in this Application form are untrue, and you have suppressed or mis-stated any facts and/or should any information given by you alter between the date of this Application form and the inception date of the insurance to which this Application form relates you must immediately notify us.

You authorise us to collect or disclose any personal information relating to this insurance to any insurer or insurance reference service. Where you have provided information about another individual (for example, a relative, employee or client), you have or you will make the individual aware of that fact and the section in the Policy on "The way we handle your personal information".

You agree that you have read and understood this notice by doing any of the following:

(a) Signing and returning a copy of this form; or

(b) Providing the information requested and returning the form to us; or

(c) Providing us with instructions to place the policy.