Home and Contents Insurance

Landlord insurance is to ensure the buildings or buildings and contents for a property that is let out to tenants

Insured Details

Insured Name

Occupancy Type

Property Address

Street Address

Suburb/Town

State

Post code

Occupancy Type

Building Type

What Year Was You Property Built?

What Are The External Walls Made Of? If More Than One Material, Choose The Most Commonly Used

What Is The Roof Made Of? If More Than One Material, Choose The Most Commonly Used

What Is The Quality Standard Of Your Property?

Is There A Swimming Pool, Outdoor Spa Or Lift At The Property For Which You Are Liable For?

For Houses, How Many Stories Does Your House Have?

For Units, What Floor Is The Property Located On?

Property Security Details

What Best Describes The security On The Properties External Doors?

What Best Describes The Security On The Properties Windows?

What Type Of Alarm Do You Have?

Cover Details

Cover Type

Building Sum Insured ($)

Contents Sum Insured ($)

Public Liability Sum Insured ($)

Do You Require Special Contents To Be Insured? (special Content Are Items, Sets, Collections And/or Pairs Of High Value)

Please List The Special Contents Items And Sums Insured: (include Fixtures And Fittings Installed In Strata Unit)

Property Details

Is The Property For Sale?

Is The Property Currently Undergoing Renovations Or Scheduled For Demolition?

Is The Property Strata Titled?

Is The Building Structurally Sound And Well Maintained?

Is The Building Mortgaged?

Name Of Mortgagee?

Is The Property Under A Heritage Listing Or National Trust Order?

Is The Property A Student Accommodation, Motel Or Hostel Accommodation, Bed And Breakfast Or Boarding House Accommodation?

Is The Property Currently Vacant Or Expected To Be Unoccupied For More Than 90 Continuous Days?

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

Do you want to nominate the excess?

How much Excess Do You Want For the Building??

How Much Excess Do You Want For Contents?

Claims History

Have you (the insured) suffered any Loss Or Damage, or had any claims Made Against You In The Last 3 Years?

Claims Details (year, Type Of Claim, Claim Amount)

Disclosures

Has the land where the house is situated been flooded or inundated with water in the last 10 years?

Has the Insured: 1) Ever had an insurance policy cancelled, declined or terms imposed? 2. During the past five years: (a) been declared bankrupt or insolvent? (b) been convicted of a criminal offence?

Are There Any Other Important Notes Or Disclosures For The Insurer

ACCEPTANCE

If any of the statements in this Application form are untrue, and you have suppressed or mis-stated any facts and/or should any information given by you alter between the date of this Application form and the inception date of the insurance to which this Application form relates you must immediately notify us. You authorise us to collect or disclose any personal information relating to this insurance to any insurer or insurance reference service. Where you have provided information about another individual (for example, a relative, employee or client), you have or you will make the individual aware of that fact and the section in the Policy on "The way we handle your personal information". You agree that you have read and understood this notice by doing any of the following: (a) returning a copy of this form; or (b) Providing the information requested and returning the form to us; or (c) Providing us with instructions to place the policy.

DUTY TO NOT MAKE A MISREPRESENTATION

Before you renew or vary your policy, you have a duty under the Insurance Contracts Act 1984 (ICA) to take reasonable care not to make a misrepresentation to the insurer (your duty). Your duty applies only in respect of your policy that is a consumer insurance contract, which is a term defined in the ICA. This notice includes information you have previously told us that is relevant to your policy, which we passed on to the insurer. The insurer requires you to contact us to tell us if this information is incorrect, or if it has changed. If you do not tell us about a change to something you have previously told us, the insurer will take this to mean that there is no change. To ensure you meet your duty, when you contact us to advise of any information that is incorrect or has changed, the updated information you give us must be truthful, accurate and complete. If you fail to meet your duty, the insurer may be able to cancel your contract or reduce the amount it will pay if you make a claim, or both. If your failure is fraudulent, the insurer may be able to refuse to pay a claim and treat the contract as if it never existed.

DATE

Name of the person submitting this policy

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