• Home & Contents Insurance Application Form

    Please fill out all sections accurately to help us process your insurance application efficiently.
  • Date of Birth*
     / /
    2 digit day, 2 digit month, 4 digit year
  • Format: +61 400000000.
  • All Windows Key Locked*
  • All Windows Bars and Grills*
  • External Door Deadlocks*
  • Is the structure sound and well maintained?*
  • Has the land ever been flooded?*
  • Will the property be unoccupied for any period of 60 days or more?*
  • Have you had any claims in the last 5 years?*
  • Do you conduct/run a business from your home?*
  • Will the property or will the property be leased or sub leased at any stage?*
  • Is it part of National Rent Affordability Scheme, or managed by a Gov Welfare Agency?*
  • Will the property to be used for holiday and/or short term (< 3 months) letting?*

  • Client Consent – General Insurance

    I understand my broker may receive a commission from the insurer for arranging, renewing, or varying my insurance.

    - Commission is usually 5–20% of the base premium.
    - It is paid by the insurer, not added on top of my premium.
    - It is included in the premium shown on quotes and invoices provided to me.

    This commission covers the broker’s services in sourcing, arranging, and managing my insurance.

    This is a legal requirement under the Corporations Act 2001 (specifically the conflicted remuneration provisions in Part 7.7A) and upcoming Quality of Advice reforms.

    I consent to my broker receiving this commission. 

     
  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: