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Emergency Contacts
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Home
About Us
About Us
Why use an Insurance Broker
Why have Insurance?
Understanding Risk
Farm
Property
Farm Motor
Crop
Livestock
Theft of Livestock
Business
Business
Business Interruption
Office
Retail
Trades
Manufacturing
Workers Compensation
Cyber Insurance
Personal
Home
Contents
Landlords
Residential Strata
Car
Caravan
Travel
Pleasure Craft
Specialty
Professional Indemnity
Liability Insurance
Construction Insurance
Marine Transit
Transport & Logistics
Sports Insurance
rma network
Livestock (Stud) Insurance Training
Livestock Transit Insurance Training
Members Professional Indemnity
Members Business Insurance
Members Staff Insurance
Stud Stock Insurance
Transit Insurance
Transit Claim
Members Crop Insurance
Contact
Contact Us
Emergency Contacts
Claims
Landlords Quote
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Landlords Quote
Landlords Quote
RMAadmin
2016-05-26T05:22:41+00:00
Insured Details
Insured name:
Email Address:
Contact No:
Date of birth of the oldest insured (dd/mm/yyyy):
Cover Details
Current Excess:
300
400
500
600
600
700
800
900
1000
1500
2000
Current Insurer:
AAMI
Allianz
Ansvar
APIA
Bendigo Bank
Budget
Caliden
CGU
Coles
CommInsure
GIO
Lumley
MANSION
NAB
NRMA
Other
QBE
RAA
RAC
RACQ
RACV
Real Insuranc
e
RESILIUM
SGIC
SGIO
Suncorp
TIO
VERO
WESTPAC
WFI
Youi
Elders
Is the property managed by a Licensed Property Management Agent?
Yes
No
Is the property part of a strata title?
Yes
No
Strata title mortgage protection required?
Yes
No
Rent default and theft by tenant required?
Yes
No
Weekly Rent amount?
Building Details/Occupancy & Location
Exact Address of situation
Approximate Year built
Postcode
Suburb/Town
State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Occupied by
Owner
Rented
Other Family Members
Unoccupied
Building type
House
Unit
Flat
Homestead
Wall Construction
Brick Vaneer
Double Brick
Timber/Weatherboard
Fibro
Asbestos
Mud Brick
Foundation Construction
Concrete Slab
Stilts
Wooden Stumps
Concrete Stumps
Other
Roof Construction
Tiled
Iron
Asbestos
Other
Is your home located on a site exceeding 20,000 square metres?
Yes
No
Claim
How many total claims (including thefts/burglaries) on building/contents have you, or any of the occupants made in the last five years?
How many burglaries or thefts have you, or any of the occupants experienced at this address in the last five years?
Claims Details
Description of claim
Year
Amount
Click here to add other Claim
Building
Sum insured
Contents
Sum Insured
Optional Cover
Flood Cover
Yes
No
Security details
Deadlocks on all external doors?
Yes
No
Key operated window locks or grilles on all external windows?
Yes
No
Alarm type
None
Local Alarm
Back to Base – monitored
Underwriting information
Have you or anyone permanently residing with you, been convicted of arson, theft, fraud or violence against any person or property in the last 10 years?
Yes
No
Have you or anyone permanently residing with you, been convicted of any crime involving drugs, dishonesty, arson, theft, fraud or violence against any person or property in the last 5 years ?
Yes
No
During the last 3 years, has any insurer refused to insure your home and/or contents?
Is the building either:
Yes
No
1. Being let or rented on a commercial basis eg. hotels/hostel/motels, guest house, boarding house?
Or
Yes
No
2. Poorly constructed, badly maintained or subject to a demolition order?
Yes
No
Additional Information
Is the building National Trust classified or heritage listed?
Yes
No
Is the building being shared by more than 3 unrelated persons?
Yes
No
Is any part of the risk address used for any business, trade or profession, other than a home office, or is the building located on a farm or hobby farm?
Yes
No
Has or will the building be unoccupied for any period in excess of 60 consecutive days?
Yes
No
Home Contents in Transit Insurance
Are you moving house shortly or as a result of this quotation?
Yes
No
If you are moving premises either with a professional carrier or yourself you can purchase Home Contents in Transit Insurance to protect your assets whilst being moved. Please provide some additional details below to allow us to provide a quote and an explanation of cover.
Information
Move Date:
Professional Removalist or Own Move?
Professional Carriers
Own Move
Including Motor Vehicles/Motor Bikes/Caravans/Boats?
Yes
No
Including Live Plants?
Yes
No
Including Works of Art, Antiques etc?
Yes
No
Movement
Within Australia or Overseas:
Australia
Overseas
Please provide details of from and to
From Postcode or Town
To Postcode or Town
Sum Insured details
Home Contents:
Antiques/Paintings:
Cars/Boats etc:
Storage
Is storage required as part of the move?
Yes
No
Months
1
2
3
4
5
6
7
8
9
10
11
12
Value Stored
Postcode of Storage
Note that all fields are mandatory and the form will not submit with empty selections.
Form may take several sections to send.
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