Home and Contents Insurance Form 1 Your Details 2 Insured Property Details 3 Cover Required 4 Declaration and Submit Introduction Please answer all questions in this proposal form. Blanks and/or dashes, or answers "known to underwriters or brokers" or "N/A" are not acceptable and will delay processing of this application. Any documents attached to this document form part of this application. Where appropriate, please tick the yes or no box which best indicates your reply. If you have any questions whilst completing this insurance proposal form, please call our office. Primary Contact First Name Last Name Email Phone Mobile Details about the Insured (You) Insurance is a contract between the named insured and the insurer. You should name any adult who lives at the premise. Whether that is your spouse / partner, adult children / siblings, or your parents to ensure any contents owned by them are insured, and any liability associated with living at the premise is covered by this policy. If you do not list them they may not be insured. As the primary contact, are you also the Main Insured person on this policy? YesNo Insured Person 1 If you are not the main insured, please list the full legal name of the first insured person to be listed on this policy. Do you need anyone else to be listed as an insured on the policy? YesNo Insured Person 2 Insured Person 3 Insured Person 4 Insured Person 5 Number of unrelated persons living in the property What is the date of birth of the oldest insured person? If you own the building, and the building is owned by a company or trust, please list the full entity name here: Would you like to list an interested party such as your bank or finance provider? YesNo Please list any interested parties, such as a bank or financier that is required to be noted as an Interested Party Occupancy Type Owner Occupier – I / we own this property and live in it tooI am a Renter (You rent but do not own this property)I am a Landlord (You own and rent this property to others on a Long Term Lease)Short Term Rental (Air BNB / Stayz etc)Short Term Rental (Managed by a Real Estate)Holiday Home used only by Family & FriendsVacant and UnoccupiedOther Current Weekly Rental Income Previous Next Insured Property Details Australia Is the property currently unoccupied or expected to be unoccupied for more than 90 continuous days during the period of cover? YesNo Is the property used for any business or income generating activity other than a home office? YesNo What kind of business do you operate from the premise? Accounting / BookkeepingAdvertising AgencyAgistmentArchitect / Drafting ServiceArts & Crafts (Gift, Candle, Pottery)Audio Visual Media StreamingAuthor / Freelance Writer / IllustratorBnB – AirBNB or Stayz ListingBnB – Hotel / Paid AccommodationBrewing / DistillingChildcare Service (Licensed)Consultancy / Business ManagementComputer ConsultantDesign ServicesDigital MarketingDoctor / Dentist Room(s)Dog Grooming / Pet SittingFarmingFinancial Planning / Asset ManagementFinance / Mortgage BrokingFood Services (Baking / Cooking)Freelance Artist / PerformerHairdressing / Beauty / BarberHobby Farming (No Income)Insurance Broker / AgentInternet Blogger / InfluencerJewellery Making or RetailingLegal ServicesMechanic / Repair / PartsMusician / RecordingNutritionist / DieticianPersonal TrainerPhotographerPhysiotherapist / ChiropractorProfessional Beauty ServicesPsychologist / CounsellorReal Estate / ConveyancingTravel AgencyTutoringVeterinary ServicesWebsite / Software DesignWedding / Event PlannerOther Do you have separate insurance in place for these business activities? YesNo Who is the insurer for your Business Insurance? Currently under renovation or intend to renovate in the next 12 months? YesNo In poor condition or poorly maintained? YesNo Under any heritage listing or National Trust order? YesNo Used as a hostel, bed and breakfast, or guesthouse? YesNo Located on a farm or acreage? YesNo Do you earn more than $50,000 per year from farming or agistment? YesNo Land size in acres For hectares, add ha after the number (example: 5ha) Do you have any farm animals on your property? YesNo What type of farm animals do you have? (List all) Security Details Deadlocks on all external doors? YesNo Keyed locks on all external windows? YesNo Is a security alarm installed? YesNo What type of alarm? Local alarmMonitored by security companyMonitored by me (mobile notification) Keycard or swipecard access? YesNo Do you have CCTV? YesNo Is your CCTV: Doorbell camera onlyExternal cameras onlyInternal cameras onlyExternal and internal camerasMonitored by an external security company Any other security details Previous Next What cover you would like to include Building - Do you require insurance for your building? —Please choose an option—Yes, my building is a free-standing homeYes, my building is a townhouse / villaYes, my building is a duplex / triplex / quadplexYes, my building is an apartment / unit / flatNo, I do not require building coverNot sure How many units are there in total in your building? Unsure what your building replacement value is? Please visit the Insurance Council of Australia for online calculators - Online Calculators Building Replacement Value Please select your preferred building excess, you can select up to 3 options. $600$700$750$800$900$1,000$1,250$1,500$1,750$2,000$2,500$3,000$3,500$4,000$5,000$10,000 Contents - Do you want to include cover for your Personal Belongings and Home Contents? —Please choose an option—Yes, I require cover for my Home Contents & Belongings at the home onlyYes, I require cover for my Home Contents & Belongings at the home and away from homeNo, I do not require contents coverNot sure Contents Replacement Value Please select your preferred contents excess, you can select up to 3 options. $600$700$750$800$900$1,000$1,250$1,500$1,750$2,000$2,500$3,000$3,500$4,000$5,000$10,000 Important Note about Contents All policies have a maximum value per item or limit per item for contents that are not specified. Many direct insurers have a limit of $1,000 which isn’t very much for jewellery, musical equipment, cameras, or sporting equipment, particularly e-bikes. As we use multiple insurers, the quotes we arrange could have different limits. Usually this ranges from $10,000 per item through to $20,000 per item not specified. If you have high value items that aren’t specified, please let us know so we can recommend the right policy. Would you like your policy to include cover for: Flood Damage YesNo Accidental Damage YesNo Contents away from your home YesNo This is recommended when you take your personal property away from your home, whether this is jewellery, laptops or electronics, sporting equipment, cameras or musical equipment to provide cover for these items when you are away from your home. What geographical limits do you require? Australia & New Zealand OnlyWorldwide Personal Cyber Insurance for your Personal Data YesNo This additional cover helps protect you, your data, bank accounts and your identity from online/cyber crime and identity theft. Business Owned Contents or Stock at your home, garage, or shed? YesNo Contents valued at more than $10,000 per item? YesNo Specified Contents YesNo Specified Contents / Valuables Specified Content 1 Description Sum Insured Is cover required for this item away from the home? YesNo Specified Content 2 Description Sum Insured Is cover required for this item away from the home? YesNo Previous Next Insurance Claims History and your Duty not to Misrepresent Claims and Disclosure Questions The questions we ask below will help us arrange quotes for you, however, you will be required to check similar questions which may be worded differently on any final application form or "what you told us" form before you make payment of any policy we arrange for you. You must check these forms we send you each and every year to ensure the answers remain accurate and notify us of any changes that are required. Have you had any claims in the last five years? YesNo Number of Claims you have had in the last 5 years Do you have any damage to your home that you have not yet made a claim for, or, which was not disclosed to the insurer at the time of damage? YesNo Are you aware of any damage to your home for which you intend to claim but have not yet claimed from your current insurer? YesNo Have you or anyone who will be insured by this policy been bankrupt or a company that you were a director of placed into receivership in the past 10 years? YesNo Have you, or anyone who will be insured by this policy, had a criminal conviction in the past 10 years (excluding speeding or parking fines)? YesNo Please provide further details Who is your current insurer When does your current policy expire? When would you like this policy to commence? Financial Service Guide (FSG) Our Financial Service Guide (FSG) explains who we are and the license under which we operate. You should read our FSG before accepting any policy or advice from us. You can read our FSG online at www.oraclegroup.com.au/fsg. Cooling Off If you are not completely satisfied with your policy, you may cancel it by notifying us in writing within 30 days of cover having commenced. You will receive a refund of the amount you have paid unless something has occurred for which a claim may become payable under the policy. Confirming Transactions You may contact us, in writing (which is always required if you are advising cancellation) or by phone, to confirm any transaction under your policy. Any transaction will be documented by us as quickly as possible. Code of Practice A self-regulatory Code of Practice exists for the general insurance industry, designed to raise overall standards. We have adopted the Code, details of which can be obtained from your insurance broker or our office. Complaints If you do not agree with any decision we make in relation to your insurance, please write to us stating what you disagree with and why. We will then either resolve or attempt to resolve your complaint immediately or refer the matter to our Internal Dispute Resolution Committee (IDRC). If you are not satisfied with a decision of the IDRC, the matter may be referred to an independent alternative dispute resolution body, the Australian Financial Complaints Authority (AFCA) provided it falls within their jurisdiction. Privacy We respect your privacy and comply with the Privacy Act and the National Principles. A copy of our Privacy policy is available upon request or on our website. Your duty when you apply for insurance Before you enter into an insurance contract, you have a duty to not misrepresent under the Insurance Contracts Act 1984. By law, you must take reasonable care not to make a misrepresentation. This means giving us true, complete and accurate answers to our questions, including where you provide information on someone else’s behalf. We use your answers to decide whether to insure you and on what terms. If you do not tell us something If any of your answers are misleading, incomplete, inaccurate or fraudulent we may reduce or not pay a claim, cancel your policy or treat it as if it never existed. I hereby declare that: My attention has been drawn to the important notices accompanying this Application form and further I have read these notices carefully and acknowledge my understanding of their content by my signature below. The above statements are true, and I have not suppressed or mis-stated any facts and should any information given by me alter between the date of this Application form and the inception date of the insurance to which this Application relates I shall give immediately notice thereof. I authorise you to collect or disclose any personal information relating to this insurance to or from any other insurers or insurance reference service. Where I have provided information about another individual (for example, an employee, or client), I declare that the individual has been or will be made aware of that fact and the section in the Policy on "The way we handle your personal information". I also confirm that the undersigned is authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this Application form and I complete this Application form on their behalf. Details of Person Completing this proposal form First Name Last Name Signature Date Previous Next