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Home & Content Insurance

insurance_4.1.1
insurance_4.1.1

For an obligation-free home and contents 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

Property Details
What is the insured address?
What year was the building built?
What type of building is it?





What are the external walls make of?






What is the roof construction?





How is the building occupied?




What Security does the property have?
Please select from the following options:

Windows




Doors

All external h
Key locks or patio bolts are fitted to all external s
Additional Security


What value would you like to insure the building for?
What value would you like to insure the contents for?

Other Details
Do you currently have cover away from home for your valuables or personal property?


If yes, please give description & value of items:
Do you require flood cover? (An extra premium may apply!)

Date you would like the policy to commence:
Please provide details of applicants’ insurance claims in the last 5 years:
Date Type of loss Amount of Claim
Have any of the applicants ever had any insurance delined or cancelled, renewal refused or special terms imposed?


If yes, please give details:
Have any of the applicants been charged or convicted of any criminal offenses in the last 10 years?


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


Published Date: April 2, 2008
Printed from http://www.apiqld.com.au/page/Home_Home_Office/Home__Contents_Insurance_/
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