Add Contents

General Details
What would you like us to do? (our Scope of Service)
Policy Number
If known
Name of person answering questions

First NameLast Name
Are you to be the insured person?
What is your date of birth

DayMonthYear
What is your e-mail
What is your best contact number

Area CodePhone Number
Name of person to be insured:

First NameLast Name
What is their date of birth

DayMonthYear
What is their e-mail
example@example.com
What is their best contact number

Area CodePhone Number
Do we need to note a second person as an additional insured?
What is their full name

First NameLast Name
What is their date of birth

DayMonthYear
What is their e-mail
What is their best contact number

Area CodePhone Number
Postal address
How do you want to pay your premiums?
What date do you want cover effective from?

DayMonthYear
Contents
Address where contents are located
this needs to be house number, street, suburb, town, postcode
Type of property where the contents are located

Other
Who uses the contents
Who uses the contents
Click here for a Home Contents Sum Insured Calculator to help you get a general indication of some of the contents that might be found in a home. The values used are notional only and do not take into account the quantity, quality, age or model of your contents.

Once you've completed this, please email us a copy to info@teamrussell.co.nz.
Attach a copy of your Home Contents Sum Insured Calculation (or email us a copy as above)

Browse Files

Cancelof
Nominated Sum Insured - ($)
Is this figure?
Type of cover required
Which extra cover do you require on the Flexi Plan (this is a restricted cover; for more info check policy document)
Are any contents used for business purposes?
Please provide more details regarding contents used for business purposes
Security of contents?
Please see below a list of items that need to be specified:
List any items to specify:
Item type, description and value ($)
If available, please upload a valuation for jewellery

Upload a File

Cancelof
Standard Excess ($)
Have you made any contents related insurance claims within the last 12 months?
Details of claim(s)
Moral Questions

Have you or your family members, or any other person or entity to be covered by the insurance:
Made more than two claims in the last two years:
Please provide full details, including the date of the incident, and a brief description:
Been bankrupt in the last 10 years?
Please provide full details, including the date of the incident, and a brief description:
Been aware of any damage from flooding, landslip or earthquake at any address relating to this policy?
Please provide full details, including the date of the incident, and a brief description:
Had any insurance declined, cancelled, avoided, renewal refused, terms or conditions imposed or claim denied?
Please provide full details, including the date of the incident, and a brief description:
Engaged in any criminal activity or had any criminal convictions, acquittals or diversions, or have any criminal prosecutions pending?
Please provide full details, including the date of the incident, and a brief description:
Declaration & Privacy Statement
Authorisation
Please click here to open our Scope of Service.
I acknowledge I have read, and understand the Scope of Service including the Adviser disclosure.
Additional notes or queries that may affect your insurance?
Is there anything else you would like assistance with? (we will contact you)
Should be Empty:

General Details

Contents

Moral Questions

Declaration & Privacy Statement

Authorisation