QUOTE Request a Quote Fill out the form below, and we’ll get back to you as soon as possible. "*" indicates required fields Name* First Last Phone*Email* Type of Insurance*BusinessHome and ContentsLandlordsMotor VehicleNot Sure - Request a Call BackAre you registered as a?*CompanySole TraderOtherABNWebsite Please provide a description of your business activity*What is your turnover/yearly revenue?*How many staff do you employ?*Do you know what type of insurance you need?*YesNo - I need assistanceWhat type of business insurance do you require?*Public Liability InsuranceProfessional IndemnityCyber InsuranceCommercial Property OwnerManagement LiabilityTrades Tools CoverOtherYour house address* Street Address City State Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country The Date of Birth of the Eldest Person Residing at your house*Year your house was built*Have you updated the switchboard, electrical wiring and plumbing?*YesNoUnsureWhat are your walls made of?*BrickBrick VeneerWeatherboardWoodHardiplankConcreteOtherPlease specify*What is your roof made of?*Colourbond/Metal CoveringTilesOtherPlease specify*Do you have key locks on all doors and windows*YesNoDoors OnlyDo you have any additional security*Back to base alarmSecurity cameras monitoredSecurity cameras on your phoneOtherNoSelect as many as applicableHow many bedrooms does your house have?*How many bathrooms?*Do you have a mortgage?*YesNoWho is the lender?*How much would it cost to rebuild your house?*What amount would you like your contents to be insured for?*Do you have any valuables* you would like insured?*NoYesUnsurePlease provide a value and brief description of the items*Your house address* Street Address City State Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country Year your house was built*Please specify*Have you updated the switchboard, electrical wiring and plumbing?*YesNoUnsureWhat are your walls made of?*BrickBrick VeneerWeatherboardWoodHardiplankConcreteOtherPlease specify*What is your roof made of?*Colourbond/Metal CoveringTilesOtherPlease specify*Do you have key locks on all doors and windows*YesNoDoors OnlyDo you have any additional security*Back to base alarmSecurity cameras monitoredSecurity cameras on your phoneOtherNoSelect as many as applicableHow many bedrooms does your house have?*How many bathrooms?*Do you have a mortgage?*YesNoWho is the lender?*How much would it cost to rebuild your house?*What amount would you like your contents to be insured for?*This is small air-conditioning units, carpet, floating floor and window furnishings Is your property a long term rental or short term?*Long Term RentalShort Term RentalHow much rent do you make a week?*Do you have a Property Manager?*YesNoWho is your property manager*Do you want to protect*Personal CarBusiness VehicleFleetOther (Trailers, Mobile Machinery, Aircraft etc)Date of Birth of driver* DD slash MM slash YYYY Your vehicle registration*Address where your car is parked at night* Street Address City State Post Code Would you like to list any other drivers?*YesNoProvide Full Name & Date of Birth*Have you lost any demerit points on your licence*YesNoUnsureIs your car financed?*YesNoWho is your car financed with?*Add another Car Date of Birth of driver* DD slash MM slash YYYY Your vehicle registration*Address where your car is parked at night* Street Address City State Post Code Would you like to list any other drivers?*YesNoProvide Full Name & Date of Birth*Have you lost any demerit points on your licence*YesNoUnsureIs your car financed?*YesNoWho is your car financed with?*What is your business occupation*Date of birth of main driver* DD slash MM slash YYYY What is the street address of where the vehicle is parked at night* Street Address City State Post Code What is your vehicles replacement value?*Does your vehicle have any accessories?*YesNoPlease list accessories including replacement value*Type of vehicle*PassengerTruckOtherIs your truck over 10T?*YesNoWhat does your truck carry*How far do you travel from your location eg 50km, or Australia Wide*Your Vehicle Rego*Has the main driver lost any demerit points from their licence?*YesNoUnsureAdd another vehicle What is your business occupation*Date of birth of main driver* DD slash MM slash YYYY What is the street address of where the vehicle is parked at night* Street Address City State Post Code What is your vehicles replacement value?*Does your vehicle have any accessories?*YesNoPlease list accessories including replacement value*Type of vehicle*PassengerTruckOtherIs your truck over 10T?*YesNoWhat does your truck carry*How far do you travel from your location eg 50km, or Australia Wide*Your Vehicle Rego*Has the main driver lost any demerit points from their licence?*YesNoUnsureDo you have 12 or more vehicles to insure?*YesNoHow many vehicles do you need to insure?*Please complete the Business car quote form. What is your business occupation*One of our team will call you for a comprehensive list of your vehicles, uses and how far you will be driving them. Is this a business vehicle?*YesNoWhat is your occupation?*What type of vehicle would you like to insure?*Is it registered?*YesNoWhat is the registration?*Provide year, make, model*YearMakeModel Add RemoveWhat is your vehicles replacement value?*Add another vehicle Is this a business vehicle?YesNoWhat is your occupation?*What type of vehicle would you like to insure?*Is it registered?*YesNoWhat is the registration?*Provide year, make, model*YearMakeModel Add RemoveWhat is your vehicles replacement value?*NameThis field is for validation purposes and should be left unchanged. Δ
