API Leisure & Lifestyle


Motor Insurance

Allow us to arrange the most suitable and competitive insurance for your car, from our network of reputable insurance suppliers. Our search, qualified advice and administration assistance is completely free of charge.

For an obligation-free vehicle insurance quote simply fill in your details below and one of our consultants will contact you within the next business day. Please note that the quotation will be arranged on the basis of the information provided, so if any information is inaccurate or incomplete, this may alter the terms or acceptance of cover.

Quote Request


Applicants Details
Name
Daytime phone number
Mobile
Email
Date of birth

Vehicle Details
Year of manufacture?
Make? (i.e. Holden, Toyota, Ford)
Model? (i.e. Commodore, Corolla, Falcon)
Body type? (i.e. hatchback, sedan, ute)
Transmission?

Number of cylinders?
Type of cover required:
Fire & Theft
Use of vehicle:


Details and value of any accessories/modifications fitted to the vehicle:
Accessory / Modification Details Value
What type of finance do you have on the vehicle?


Where is the vehicle parked at night?



Address of where the vehicle will be parked:

Main Driver Details
Date of birth of most frequent driver:
Gender of most frequent driver:

What year did they obtain their Australian drivers licence?
What is your current no claim bonus entitlement?

1st Additional Driver Details
Date of birth:
Gender:
What year did they obtain their Australian drivers licence?
What percentage of time will they drive the vehicle?
Do they have a vehicle registered in their own name?


2nd Additional Driver Details
Date of birth:
Gender:
What year did they obtain their Australian drivers licence?
What percentage of time will they drive the vehicle?
Do they have a vehicle registered in their own name?

Other Details
Would you like to remove the excess for windscreen claims?

Would you like a 'Hire Car after Accident' extension?

Is the vehicle roadworthy, free from damage and registered?

Have any drivers had any motor vehicle accidents or lodged any claims in the last 5 years?

If yes, please provide date, incident details and amount of claim
Date Details Claim Value
Have any drivers had any traffic convictions in the last 5 years?

If yes, please provide details
Have any drivers had their driving licence suspended, cancelled or restricted in the last 5 years?

If yes, please provide details
Has the applicant or any drivers been convicted of a criminal offence in the last 10 years?

If yes, please provide details
Has the applicant or any driver had insurance declined or cancelled, refused renewal or special terms imposed?

If yes, please provide details
Do you wish to pay on an annual basis or by monthly installments?

Date you would like the policy to commence:
Thank you, one of our consultants will be in contact within the next business day.