Step 1 of 8 - Your Name 12% Can I start with your name?First Name*Last Name* Nice to meet you! What type of cover are you looking for?Cover Type* Thanks for your selection! Where do you currently live?Current Address* Street Address City State Postcode Great! What are your building and contents sum insured?Great! What is your building sum insured?Building Sum insured*Great! What is your contents sum insured?Contents Sum insured*Do you require cover for any portable items outside the insured address?* Yes No How much do you need?Do you require additional cover for valuable items?* Yes No How much do you need? Can you tell us about your home?Building type* Are you currently insured?* Yes No Who is the current insurerIs business conducted from home?* Yes No Occupancy typeSelect one...Owner OccupiedRent/LeaseHoliday HomeYear the building was constructed?What is the wall constructed of?Select one...Double BrickBrick vennerAluminiumFibro/Asbestoshardiplank/HardiflexConcreteSteelStoneVinyl CladdingWeatherboard/WoodSandwich FoamMud BrickStrawOtherWhat is the roof constructed of?Select one...TileTin/ Steel / ColourbondIron (Corrugated)AluminiumFibro/AsbestosConcreteSlateThatchTimberQuality of the buildingSelect one...Standard qualityAbove AverageTop of the rangeHow many storeys in the building?*Select one...123 or moreSplit levels are considered separate levels.Will the property ever be unoccupied for more than 100 days?* Yes No Is the property poorly maintained or in poor condition?* Yes No Is the property under construction/renovation?* Yes No Is the property heritage listed?* Yes No Can you tell us about your home security?Type of security on external doors* What type of window security do you have?* Type of alarm* Lets talk about your claims history for the past 3 yearsNumber of claims in last three years*Select one...0123456789+When did you make your most recent claim?Select one...Never202220212020201920182017201620152014Have you been declined insurance?* Yes No Have you had a claim declined?* Yes No Have you had any criminal convictions for fraud or arson?* Yes No Almost done! May I grab a few quick details?When would you like the policy to be effective from? DD slash MM slash YYYY Add this to an existing package?* Yes No Payment Type* Annual Instalments Email* Phone*Date of birth of the oldest insured* DD slash MM slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
