Complete the form below to be sent a quote through to your email.
Contact person*
Email address*
Policy number
Risk Start Date*
Renewal Date
Cover Type* HomePlan Maxi Sum Insured ReplacementHomePlan Flexi Sum Insured Indemnity
Location Address*
Have you made any house (excluding contents) related claims within the last 12 months?* YesNo
Is the home on a lifestyle block or farm?* YesNoIf Yes: A home on a lifestyle block or farm cannot be covered under this policy
How many self-contained units are at this location?* —Please choose an option—Home onlyHome plus 1 unitHome plus 2 unitsHome plus 3 unitsMore than 3 units
If home plus units, will any of the units cost less than $150,000 to rebuild?* YesNo
If Yes, enter your sum insured for each unit
What is the sum insured of your home?* The sum insured amount should represent the cost of rebuilding the existing home and any self-contained unit(s). See the resources page for the Cordell calculator link
What type of building is the main home?* FreestandingAttachedOther
If other, details of type of building
How is the home used the majority of the time?* Owner occupied HomeRental propertyOwner occupied home and rentalHoliday home owner and familyUnoccupied homeHoliday home owner and casual lettingOther
If other, details for home used
Is this home part of a multi unit or Body Corporate complex?* YesNo
Does this home have a monitored smoke or heat detector?* YesNo
What year was this home built?*
If pre 1945:
Has this home been fully re-wired since 1945? YesNoN/A
Does this home have any scrim walls? YesNoN/A
Has the Historic Places Trust placed any restrictions on preservation orders on this home? YesNoN/A
Are there any entries against the certificate of title for this home? YesNoN/A
Is any form of business run from this home?* YesNo
If yes:
Businesss type Home officeQualified MedicalB&B or Homestay or similar (<50% of home)B&B or Homestay or similar (>50% of home)OtherN/A
If other, what type of business?
Is there a mortgage on this home?* YesNo
Mortgagee name
Type of of mortgagee
What excess option would you like?* $400 Excess (standard)$500 Excess$750 Excess$1000 Excess$2500 Excess$5000 Excess
Landlord Extension - do you require this? (Only available to full time tenanted houses)* YesNoCover Option Maxi - Includes Landlord's furnishings cover for $20,000 (indemnity value), Loss of Rent cover for $40,000, malicious damage by tenant for $30,000 and non-payment of rent by tenant (various limits apply) - per dwelling unit. Cover Option Flexi - Includes Landlord's furnishings cover for $5,000 (indemnity value), and loss of Rent cover for $20,000 - per dwelling unit.
How often do you and your family occupy the holiday home?
Is the holiday home leased out on a short term basis YesNoN/A
How many weeks a year is the house leased out?
Is this holiday home leased out via website/book a bach/other advertising? YesNoN/A
Do your immediate neighbours of this property occupy their homes full time? YesNoN/A
How far away are the neighbours?
Is the house on a built up area? YesNoN/A
If no, how far is your holiday home from the nearest town?
Do you arrange for anyone to mow your lawns and empty your letter-box? YesNoN/A
What type of security is there in the house? Does it have an alarm, window locks, or deadlocks? YesNoN/A
If yes, please give details
When you do not occupy your holiday home, do you:
Turn off your outside water supply YesNoN/A
Turn off your all power at the switchboard? YesNoN/A
Is your holiday home exposed to water inundation from any man made or natural water ways? YesNoN/A(including: drains, creeks rivers, beaches and similar)
Additional notes
