Landlords Insurance
Proposal Form
*
Rows
Applicant 1
Applicant 2
Full Name
Date of Birth
Contact Number
Email
RACQ Membership Level
Are you Retired?
Do you have a Seniors Card?
Policy Start Date
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PROPERTY DETAILS
Address of Property
*
Street Address
Street Address Line 2
Town
State
Postcode
Type of Building
*
Please Select
House
Flat/Apartment
Unit
Terrace
Townhouse
Semi-detached
Occupancy
*
Please Select
Rented to Tenants (long term basis)
Rented to Tenants (short term basis)
Holiday Home
Unoccupied
Wall Construction
*
Please Select
Double Brick
Brick Veneer
Concrete Blocks
Colorbond/Iron
Fibro/Asbestos
Hardiplank/Hardiflex
Timber/Weatherboard
Other (specify)
Roof Construction
*
Please Select
Corrugated Iron
Colorbond
Aluminum
Tile
Fibro/Asbestos
Concrete
Other (specify)
Built on
*
Please Select
Concrete Slab (no space between ground and floor)
Stumps/foundation (clear space between ground and floor)
Queenslander/Poles elevated off ground up to 1m
Queenslander/Poles elevated off ground up up to 2m
Queenslander/Poles elevated off ground over 2m
Year Built
*
Rows
Number of Storeys
Number of Bedrooms (inc study/office)
Number of Bathrooms
Do you have a Pool?
*
Yes
No
Do you have a Spa?
*
Yes
No
Security
*
Standard Locks on doors
Deadlocks on external doors
Security Screens on external doors
Window locks
Security Screens on windows
Monitored Alarm system
Non-Monitored Alarm system
Other
Solar Panels
*
Please Select
No Solar Panels Fitted
Standard Solar Panels Fitted
Hail ‘Resistant’ Panels Fitted
Roller Doors (not tilt doors)
*
Please Select
No roller doors
Rollers doors no bracing
Roller doors with aftermarket bracing fitted
Roller doors fitted after 2012
Roof Improvements
*
Please Select
No Improvements (original roof)
Rescrewed
Ridgcapping replaced/upgraded
Complete roof replacement (form 16 compliant)
Roof cladding replaced and sarking installed
Sheds/Outhouses
*
Please Select
None
Sheds/outhouses with NO cyclone protection Sheds/outhouses cyclone rated and anchored to concrete slab
Sheds/outhouses cyclone rated but NOT anchored to concrete slab
Do ALL windows have
*
Cyclone Shutters
Plywood Covering
Storm Shield / Tempered Glass
None
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DECLARTIONS
Mortgagee/Interested Party
Rows
Sum Insured
Excess
Cover
Building
$500
$750
$1,000
$2,000
$2,500
$3,000
$4,000
$5,000
Defined Events
Accidental Damage
Contents
$500
$750
$1,000
$2,000
$2,500
$3,000
$4,000
$5,000
Defined Events
Accidental Damage
Do you wish to take cover for:
*
Rows
Yes
No
Loss of Rent
Rent Default
Tenant Damage
Weekly rent
*
Rows
Yes
No
Is the Property structurally safe, well maintained and in Good Condition?
Is your home on more than 5 acres?
Do you expect your home to be unoccupied for more than 90 consecutive days?
Do you derive a turnover or run a business from your home?
Do you intend on doing any renovations that exceed $75,000 in the next 12 months?
Had an insurance policy cancelled, declined or terms imposed?
Have you been convicted of any criminal offence?
Have you had any claims in the past 5 Years?
If YES to any of the above, give details below:
Submit
Should be Empty: