AMSA 2025 Insurance Program Application

INFORMATION STATEMENT

Everest Risk Group (ERG)
ERG is a Corporate Authorised Representative (No 276869) of Insurance Advisernet Australia Pty Limited. (IAA - Australian Financial Services Number 240549). We suggest reviewing our Financial Services Guide for information relating to our business and how we are remunerated.

Click Here to View our Financial Services Guide

Use of information

We wish to inform you; the details you furnish us will be shared with duly authorised representatives of the Australian Men's Shed Association (AMSA) and Everest Risk Group. This sharing of information is necessary for the effective administration of the products included in the AMSA Insurance Program, as well as any other programs integral to the AMSA framework.

At Everest Risk Group, we place great importance on the confidentiality and security of your personal information. Our Privacy Policy, in accordance with the Privacy Act and the Australian Privacy Principles, outlines our approach to collecting, disclosing, and managing your personal information. By providing your information to us, you are agreeing to these procedures, unless you expressly indicate otherwise.

Should you wish to review our Privacy Policy, it is accessible via our website at https://www.insuranceadviser.net/ia-privacy-policy

Frequently Asked Questions, Summary of Coverage and Policy Wordings
Please review the Frequently Asked Questions prior to completing this declaration.

Many of the questions you may have will be answered within this document.

A copy of the base policy wordings, along with the Frequently Asked Questions guide and Summary of Covers can be accessed by visiting https://everestrg.com.au/amsa-renewalstorage/ and using the password AMSA - The policy schedules will be available following renewal

Australian Mens Shed Association (AMSA) Disclosure of General Information

As a member of the Australian Men's Shed Association (AMSA), you have exclusive access to specially negotiated member coverage and premiums. In facilitating this service, AMSA acts as your advocate, negotiating coverage terms and premiums which are advantageous to eligible members.

Furthermore, AMSA serves as an intermediary between members and our IAA Authorised Representative, Everest Risk Group Pty Ltd (276869). This arrangement, provided at no additional cost to our members, includes the dissemination of essential documentation and information from ERG, such as:
- A Financial Services Guide, which includes contact details for our ERG Authorised Representative.
- Policy Schedules.
- A copy of, or access to, the relevant Product Disclosure Statement, which details the product's terms and conditions.
- Renewal notices.
- If applicable, notification of cancellation or non-renewal of policies.
It is our duty to inform you of our obligation to compensate you for any loss or damage resulting from a failure to notify you as required of the aforementioned items. In providing these services to our members, AMSA does not receive any rebates or commissions from Insurance Advisernet, its Authorised Representative (ERG), or the insurers for arranging the issue of insurance coverage.
Please select to continue...*

We have read and understood the Information Statement

Please select the category your association falls into*

Mens ShedWomens ShedCommunity ShedRepair CafeOther
Organisation Name (Full Legal Entity Name)*
Is your entity incorporated?*
As you are not incorporated, please enter the name of your Auspicing Body
Australian Business Number (If known)
Website
Postal Address*

Street Address Line 2 (if applicable)

SuburbState / Territory

Postcode
Postal Postcode*
State/Territory*
Primary Contact Person*
Member Numbers - Audits

For the purpose of completing insurance applications, it is imperative to declare all members. This encompasses not just those actively engaged in primary activities but also includes individuals involved in social events, those participating as part of Centrelink Mutual Obligation requirements, and members who may not use workshop facilities.

An important criterion for member declaration is the payment of a membership fee. Any individual paying such a fee must be counted as a member for insurance purposes.

It is crucial to understand that failing to accurately account for every member could have serious repercussions. Such an oversight may lead to a reduction in, or even the complete voiding of, a claim.

We place significant reliance on Sheds to ensure the accuracy of declared numbers. This cooperation is essential for us to continue offering the high-quality, affordable coverage Sheds have rightly come to expect from us.
Number of paid-up members as per your most recent lodged financial statement or membership ledger (including Mutual Obligation participants) – a minimum of fifteen applies.*
This figure must align with your official records as submitted to the state regulator/ACNC/ASIC or maintained for internal reporting. Discrepancies may be subject to audit.
Number of paid-up members as per your membership ledger as at the date of your last lodged financial statement (including Mutual Obligation participants).
Does your location participate in the Mutual Obligation program administered by Centrelink?*

YesNo
As you have selected yes to participating in the Mutual Obligation program, please advise the number of participants attending in a 12 month period (do not subtract this number from the number of members declared above)
Primary Email Address*
Secondary Email Address
Contact Phone Number*
Use ONLY numbers. No spaces, brackets or otherwise. Example 0400123456
Select the Date From Which Cover is to be Effective*

DayMonthYear
Where did you source your previous insurance?
Enter the details of your landlord or other interested party to be noted on your Certificate of Insurance (may not be applicable to your Shed)

Please read and acknowledge the following when completing the declaration questions.

Your Duty of Disclosure - What you must tell us

Under the Insurance Contracts Act 1984 (the Act), you have a Duty of Disclosure. You are required before you enter into, renew, vary, extend or reinstate your Policy, to tell us everything you know and that a reasonable person in the circumstances could be expected to know, is a matter that is relevant to our decision whether to insure you, and anyone else to be insured under the Policy, and if so, on what terms.

You do not have to tell us about any matter
- that diminishes the risk
- that is of common knowledge
- that we know or should know in the ordinary course of our business as an insurer, or
- which we indicate we do not want to know.
If you do not comply with your Duty of Disclosure your insurer may reduce or refuse to pay a claim or cancel your Policy.

If your non-disclosure is fraudulent your insurer may treat this Policy as never having operated.

Under-insurance

Industrial Special Risks property insurance is written on a “Reinstatement/Replacement” basis which means replacing the property destroyed or restoring the damage with new materials without any deduction for depreciation or volunteer labour.

If incorrect values are declared for insurance purposes, it can have significant implications under the Average/Co-Insurance clause of the policy:

Average/Co-Insurance Clause Activation: This clause is applied in cases of underinsurance. It essentially means if the declared value of your property or assets is less than their actual replacement value, you may not be fully insured.

Effect of Underinsurance: By declaring a value lower than the actual full replacement value, you are effectively self-insuring a portion of the risk. This means you are assuming responsibility for a part of any potential loss.

Proportionate Claim Payment: In the event of a claim, if it is found the declared value is less than the actual value, the insurer may only pay a claim amount proportionate to the declared value against the actual full value. For example, if you have declared 75% of the actual value, in the event of a claim, the insurer may only cover 75% of the loss, leaving you to fund the remaining 25%.

Importance of Accurate Valuation: It is, therefore, crucial to accurately assess and declare the value of your property and assets. This ensures you receive adequate coverage from your insurer in the event of a claim and avoids the risk of underinsurance.

Declaring incorrect values can lead to underinsurance, which may significantly impact the amount you can claim. The Average/Co-Insurance clause means you could be responsible for a portion of any loss if your declared values are lower than the actual values. Accurate valuation and declaration are key to ensuring full insurance coverage.

Waiver of Liability Agreements
Where another person would be liable to compensate you for any loss or damage otherwise covered by the policy, but you have agreed with that person either before or after the loss or damage occurred that you would not seek to recover any monies from that person, the insurer will not cover you under the policy for any such loss or damage.

General Advice Warning

The information provided is to be regarded as general advice. Whilst we may have collected risk information, your personal objectives, needs or financial situations were not taken into account when preparing this information. We recommend you consider the suitability of this general advice, in respect of your objectives, financial situation and needs before acting on it. You should obtain and consider the relevant product disclosure statement before making any decision to purchase this financial product

Your Privacy

We value your privacy. Our Privacy Policy sets out how we collect, disclose and handle personal information under the Privacy Act and the Australian Privacy Principals. By providing us such information you consent to these practices unless you tell us otherwise. Our Privacy policy is available at https://www.insuranceadviser.net/ia-privacy-policy or by contacting us.

Who do we contact with questions related to 'the insurance'

Everest Risk Group Pty Ltd
Sean McDermott (Authorised Representative # 447131)
Phone: 02 8880 0653
Email: amsa@everestrg.com.au

When sending ERG an email, please place the name of your Shed in the ‘Subject’ line.

When contacting ERG, you should be aware of our Privacy Policy. The Privacy Policy sets out how we collect, disclose and handle personal information under the Privacy Act and the Australian Privacy Principals.
Please Acknowledge your acceptance*

We have read and accept all of the above

Activities of a Shed
The activities the insurers note as being standard, for a Shed, are below. Please be aware this has changed from expiry to correct typographical errors and create consistency in the language. Coverage has not altered.

Business Description:
1. Property owners
2. Property occupiers
3. Fundraising BBQs and similar activities
4. Holding and/or organising fete’s, markets and similar events including car parking direction (not a valet service), where there are fewer than 2,500 participants, no fireworks or pyrotechnics, and each exhibitor is responsible for their own insurance coverage
5. Project work, including all workshop-type activities and subsequent installation, where statutory certification is not required
6. Project work in the community, excluding trade services where statutory certification is required
7. Mentoring and tutelage of students from the age of 12
8. Instruction of others on the correct use of workshop tools and equipment
9. Production and sale of woodwork and other products to support fundraising objectives
10. Exercise programmes for mind, body, and spirit, including a workout space where weight blocks do not exceed 10kg
11. Repairs to machinery or equipment (including lawnmowers or small calibre motorised equipment) where statutory certification is not required
12. Book Clubs, art clubs, and other non-physical recreation activities undertaken at the insured’s premises
13. Excursions, including by bicycle (excluding mountain biking) or foot, on designated tracks, pathways, and other outside locations
14. Tours and tour accompaniment within Australia
15. Provision of guest speakers on relevant topics
16. Model aircraft flying and tutelage
17. Working with local retailers to construct equipment in accordance with the manufacturer’s specifications
18. Tutelage and assistance for those with special needs
19. Cookery classes where the instructor holds a relevant food handling certificate
20. Testing and tagging of insured-owned equipment, performed by those holding the appropriate certification (not extending to equipment being readied for sale)
21. Working with participants provided from external agencies
22. Production of goods for sale (excluding electrical items)
We ask you review the above activities; and, if necessary advise of others you may perform: - Please note, the additional activities do not form part of the policy unless you are advised otherwise.

*Note: Cover for activities not noted in (A) - (V) above are not insured until confirmation is provided by the insurer/Everest Risk Group

It is not the intention of the policy to cover high hazard activities (example - welding off site)
Please acknowledge your acceptance*

We have reviewed the activities above

DO YOU HAVE ASSETS (Contents / Building) TO INSURE?

If your Shed has assets requiring insurance coverage, it is crucial to answer "Yes" to the forthcoming question.

The Standard AMSA Insurance Package offers:
- A Total Declared Value of $100,000 for Fire & Other Perils.
- Burglary coverage amounting to $15,000 for any single loss at one location.
In the instance your Shed has assets such as contents, fixtures, fittings, the building structure, or other Shed property, including those for which you are responsible for insuring, please make sure to select "Yes" in response to the next question.

It's important to note the Industrial Special Risks policy broadly covers all tangible assets under your responsibility, without making specific distinctions between 'Building' and 'Content'. This means the policy applies to buildings, contents, fixtures, fittings, and more. Accurate declaration of these assets is vital for ensuring adequate coverage.

Additional Note on Policy Exclusions:
Please be advised this policy does not include flood coverage. It is essential to consider this exclusion when assessing your insurance needs. This is not an exhaustive list of exclusions. Refer to the policy wording and schedule for a complete list.
Does your Shed require the Industrial Special Risks insurance which forms part of the AMSA Insurance Program? Industrial Special Risks covers Tangible Assets at the insured location *
Consider whether your Shed has assets/contents/fixtures/fittings/building and other Shed property requiring coverage (including property, buildings and contents you assume the responsibility to insure)
You have selected "No" in response to the previous question regarding insuring Tangible Assets under the AMSA Insurance Package's Industrial Special Risks policy. This selection indicates that your Shed has chosen not to insure any Tangible Assets, which include assets, contents, fixtures, fittings, buildings, and other Shed Property. Important Consideration: If your Shed requires insurance coverage for Contents or Building, please revisit the previous question and change your response to "Yes". If you do not require any asset coverage, please confirm below.

Property Coverage
Important Property Insurance Notes

Property Claims

All property claims must be lodged and notified, in writing, with CGU no later than 30 days after discovery, as per Condition 6 of the Industrial Special Risks policy

On the happening of any loss, destruction or damage, the Insured shall forthwith give notice thereof in writing to the Insurer(s) and shall (within thirty (30) days after such loss, destruction or damage or such further time as the Insurer(s) may in writing allow), at the Insured's own expense, deliver to the Insurer(s) a claim, in writing containing as particular an account as may be reasonably practicable of the several articles or portions of property lost, destroyed or damaged and of the amount of loss, destruction or damage thereto, having regard to their value at the time of the loss, destruction or damage, together with details of any other insurances on any property hereby insured.

The Insured shall use due diligence and do and concur in doing all things reasonably practicable to minimise any interruption of or interference with the Business to avoid or diminish the loss and shall also deliver to the Insurer(s) a statement in writing of any claim certified by the Insured's auditor, with all particulars and details reasonably practicable of the loss and shall produce and furnish all books of accounts and other business books, invoices, vouchers and all other documents, proofs, information, explanations and other evidence and facilities as may reasonably be required for investigation and verification of the claim together with (if demanded) a statutory declaration of the truth of the claim and of any matters connected therewith.

No claim under this Policy shall be payable unless you have complied with the terms of this condition.

Asset Registers and Proof of Ownership

At the time of a claim, your Shed must be able to produce an Asset Register, itemising the contents of your Shed. It is incumbent upon Sheds to prove their loss and value of each item at the time of a claim. We suggest retaining an electronic copy of your Asset Register, receipts and other proof of ownership documentation, in the cloud, for access when required.

In addition to an asset register, a video log of the shed interior and contents could also assist in quantifying your loss to the insurer in the event of destruction or major burglary.

You can download a sample Asset Register here for your own implementation

Industrial Special Risks Declared Values

Industrial Special Risks property insurance is written on a “Reinstatement/Replacement” basis which means replacing the property destroyed or restoring the damage with new materials without any deduction for depreciation or volunteer labour.

Please note the minimum, combined contents & building, declared value for the Industrial Special Risks policy is $100,000*.

You need to assess whether the declared values you have chosen are adequate every year before you renew your Policy.

*Additional charges apply for cover above this limit.

Please be aware:

For Sheds with Standard Asset and Burglary Limits: This option applies to Sheds whose total asset value is $100,000 or less, with a need for burglary coverage up to $15,000. The AMSA Insurance Program Standard Property Policy is designed to cater specifically to these requirements.

For Sheds with Higher Asset Values or Additional Locations: If your Shed's assets exceed $100,000 or if you require burglary coverage beyond $15,000, the Standard Property Policy may not fully meet your needs. In such cases, we have an alternative Property only Policy. This policy is tailored to offer comprehensive protection for Sheds with higher asset values or those operating from multiple locations.

If you have any doubts or if your needs change, feel free to contact us for guidance.
Please select to continue*

We acknowledge the Property Insurance Notes
Shed Physical Location 1

Address Line 1

Address Line 2

CityState

Postcode
Please select the declared value you require for the replacement (new for old) of your Tangible Assets (all property you are responsible to insure) for "Location 1" - Please aggregate your replacement values for all assets at the location*
$100,000 is the standard declared value provided - Any amounts higher than this (or, where you select a higher than standard burglary limit) will attract additional cost invoiced by Everest Risk Group
As you have selected the standard limits of coverage, could you please estimate the replacement value of all assets at your nominated location. We are using this for statistical use only and it will not form part of the insurance contract.
Estimated Costs for Additional Industrial Special Risks Coverage:

For Sheds seeking higher coverage limits under Industrial Special Risks, the average national cost is approximately $436.00 for every $100,000 of coverage.

For instance, if a Shed opts to insure assets with a Total Declared Value of $200,000, the average additional cost would be around $872.00.

Please note these figures are indicative estimates and may vary based on individual circumstances. They should not be considered as a formal quotation but rather as a general guide for planning purposes.
Please specify the Total Declared Value of replacement (new for old) of your Tangible Assets
You will be contacted with the additional premium required to increase to the Declared Value selected
Is the Total Amount Declared also intended to insure the building you operate from?*

YesNo
By Selecting 'Yes' to the above, you are advising that you either:
1. You own the building you operate from
2. You are legally required to insure the building
Please input replacement values in the following box. Do not enter 0 or a number equal to the number of buildings you have on site.

It is important this value reflects the true cost of replacement.
Replacement Value on full replacement conditions for all Buildings you are responsible to insure at Location 1 (aggregate values) including concrete pad and all amenities.
Replacement Value on full replacement conditions for all Contents, Stock & all other fixtures you are responsible to insure at Location 1 (aggregate values)
Total Declared Value
Burglary Cover for "Location 1" (underinsurance does not apply)*
- Standard Sublimit is $15,000 any one claim- Additional premiums apply for limits above $15,000
IMPORTANT NOTE

As you have advised you require Declared Values which fall outside the AMSA Insurance Program, additional premium is payable.

This premium is in addition to the amount you will be charged by AMSA

If you do not wish to be invoiced for this amount, please select the standard limits of cover ($100,000 for declared value & $15,000 for Burglary)
Is your property in poor condition or is it poorly maintained?*
Wall Construction*
Please provide details of the wall construction*
Roof Construction*
Please provide details of the roof construction*
Floor Construction*
Please provide details of the floor construction*
Number of Levels Including Ground Floor*
Approximate year of building construction*
Please enter only numbers as YYYY
Does your Shed have a dust extraction system installed?*

YesNo

Fire & Theft Protection Details*

	Select
Are sprinklers installed and active?
Are fire extinguishers on site; and, holding current certification?
Are there fire hoses present?
Are there smoke detectors connected; and, functioning?
Are there deadlocks on all externally accessible doors (where legally allowed)? Or are there Security Doors at all entrances/exits (where legally allowed)
Is there a connected, burglar alarm system?
Are there window locks and/or security bars on all windows?
Are there CCTV (Closed Circuit TV) monitors installed?

Do you have another location with property to insure? (Additional Costs apply and will be invoiced by Everest Risk Group)*

YesNo
Shed Physical Location 2

Street Number

Street Name

CityState

Postcode
Please select the declared value you require for the replacement (new for old) of your property (contents & building combined) for "Location 2"*
$100,000 is the minimum - additional premiums apply fo second locations
Is your property in poor condition or is it poorly maintained?
Is the Total Amount Declared also covering the building you operate from?*

YesNo
ISR 2 - Total Declared Value
Burglary Cover for "Location 2"*
- Standard Sublimit is $15,000 any one claim- Additional premiums apply for limits above $15,000
IMPORTANT NOTE

As you have advised you require Declared Values which fall outside the AMSA Insurance Program, additional premium is payable.

This premium is in addition to the amount you will be charged by AMSA
Wall Construction*
Please provide details of the wall construction*
Roof Construction*
Please provide details of the roof construction*
Floor Construction*
Please provide details of the floor construction*
Number of Levels Including Ground Floor*
Approximate year of building construction*
Please enter only numbers as YYYY

Liability
Health & Safety Risk Management

The following section is used to identify the risk management protocols your Shed has in place to identify and remove risk.

Associations & Committees generally owe an obligation to provide and maintain a safe, healthy working environment.

‘Risk management’ is a formal and structured process of identifying and managing risk. It involves assessing and then actively managing a Sheds potential exposure to injury, loss, damage, or litigation.

Effective practical strategies for reducing risk, such as safety protocols and security devices, can work together with insurance to reduce risk exposure. It is important to employ these protocols as a first step, before relying on insurance coverage.

Basic risk management steps
- Identify each risk with a thorough analysis of the association's operations, activities and business.
- The association needs to decide how to manage risks by determining the likelihood of a risk occurring against the potential consequences. For example, an association may choose to remove the risk by not continuing with a particular activity or determine existing controls are satisfactory as the impact would be very minor and it is extremely unlikely to occur.
- Treat risks by considering any existing risk control measures (eg management procedures, training, warning signs), deciding whether the existing measures are adequate and considering any additional measures that may be required.
- Monitor and review the process on a regular basis. It is important to regularly review if there has been any change in the association's risk position and, if necessary, repeat and review the process set out above.
Policies & Induction

AMSA has developed following base documents to assist you craft and develop your own risk management strategies. We recommend you review, adopt and tailor these documents to suit your individual shed circumstances.
Please also refer to the Australian Institute of Health & Welfare document relating to DIY Injuries

Do you have written & signed Policies covering the following areas? Links to all of these policies are above - Note: The working with Vulnerable Persons policy is particularly crucial, considering both your members and potential interactions with the community.*

	Select
a. Code of Conduct
b. Working with Vulnerable Persons (A vulnerable person is someone in need of special care, support, or protection due to age, disability, or risk of abuse or neglect) & Children
c. Shed Supervision & Audit Process
d. Induction/Training of New & Existing Members
f. Preventative Maintenance
g. Skills Registers
h. Induction Checklist

By what date will the items marked as "No" be implemented at your Shed?

DayMonthYear

Hazard Identification & Reduction*

	Select
Are any of your members exposed to chemicals or other toxic or carcinogenic substances which are known to be associated with conditions such as dermatitis, cancer, asbestosis or respiratory problems etc?
Are members exposed to noise levels above 85 decibels?
Have any of your members complained of repetitive strain injuries?
Have any of your members complained of stress?

As you have indicated yes, please advise what risk management has been implemented to prevent claims from occurring.

Declaration & Claims History*

	Select
Has any Claim been made, or has any negligence been alleged in the last ten (10) years against the Shed or its committee?
After enquiry, are the committee aware of any facts or circumstances which might afford valid grounds for any future claim(s) or which would indicate the probability of any such claim(s) eg Breach of Duty/Trust or Negligence/Discrimination?
Have any of the committee ever been refused the type of insurances applied for, or had similar insurance cancelled, or had an application of renewal declined, or had special terms imposed?
In the last 5 years, have any of the Shed committee been subject to administration proceedings?
In the last 5 years, have any of the Shed committee been convicted of a criminal offence?
In the last 5 years, have any of the Shed committee made any claim(s) on an insurer for loss or damage in the name of the Shed?

As you have selected 'Yes' above, please provide details including what actions have the Committee taken to prevent further losses from occurring.
Authorisation & Declaration
I the undersigned, after inquiry of the committee, declare as follows:
- I, as recorded in the meeting minutes, am authorised by the committee to make this Proposal
- I have read and understood the Notice to the Proposed Insured
- I have read this Declaration; and, acknowledge the contents of same to be true and complete
- I understand; up until a contract of insurance is entered into, we are under a continuing obligation to immediately inform your Insurer and Everest Risk Group Pty Ltd of any change in the particulars of statements contained in this Proposal or in the accompanying documents
- I understand Everest Risk Group and Insurers reserve the right to request further information in relation to this application prior to acceptance for the AMSA Insurance Package
Although the signing of this Proposal does not bind the Applicants to effect insurance, the Applicants acknowledge that the particulars and statements contained in this Declaration and in the accompanying documents shall be the basis of the contract should a Policy be issued; and further, the Applicants acknowledge that the Proposal and the accompanying documents will be incorporated in the Policy.
Acknowledgement*

I have read and agree to the statement above
Your Name*
Your position on the committee*
Shed Name*
Should be Empty:

Liability