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 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 insurer Is business conducted from home?* Yes No Occupancy typeSelect oneOwner OccupiedRent/LeaseHoliday HomeYear the building was constructed?Select year20212020201920182017201620152014201320122011200020092008200720062005200420032002200120001990 - 19991980 - 19891970 - 19791960 - 19691946 - 1959 (Post War)1914 - 1945 (War)1891 - 1913 (Federation)Pre 1890 (Victorian)What is the wall constructed of?Select oneDouble BrickBrick vennerAluminiumFibro/Asbestoshardiplank/HardiflexConcreteSteelStoneVinyl CladdingWeatherboard/WoodSandwich FoamMud BrickStrawOtherWhat is the roof constructed of?Select oneTileTin/ Steel / ColourbondIron (Corrugated)AluminiumFibro/AsbestosConcreteSlateThatchTimberQuality of the buildingSelect oneStandard qualityAbove AverageTop of the rangeHow many storeys in the building?*Select one123 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 one0123456789+When did you make your most recent claim?Select oneNever201920182017201620152014Have 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 Address* Phone* Date of birth of the oldest insured*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920CAPTCHACommentsThis field is for validation purposes and should be left unchanged.