Residential Landlord Insurance 1 Introduction 2 Insured Property 3 Cover 4 Claims & Disclosure 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. If your property is owned in a Family Trust or a company entity, you should list the company and/or Trust as the insured. As the primary contact, are you also the Main Insured person on this policy? YesNo Insured 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 another entity or anyone else to be listed as an insured on the policy? YesNo Insured 2 Insured 3 Insured 4 Insured 5 What is the date of birth of the oldest insured person 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 Other (please specify) If you own and / or occupy the premise please complete this application instead: Home & Contents Insurance This application is for Landlords Insurance as the property owner of a residential investment property. Is the property professionally managed by a property manager or do you self-manage the property? Professional Property Manager or on-site managerSelf Managed Please list the name of the appointed Real Estate or Property Manager Do you currently have tenants? YesNo How long has the property been vacant for? —Please choose an option—This is a new building, it has never had tenantsLess than 30 daysbetween 30 days and 60 daysbetween 60 days and 90 daysvacant for more than 90 days Current Weekly Rental Income Previous Next Insured Property Details —Please choose an option—AustraliaNew ZealandOther 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 ServiceArt & Crafts / Gift Basket / Gift Card Making and/or Retailing (Excluding Candle Making or Pottery)Arts & Crafts - Candle MakingArts & Crafts - PotteryAudio Visual Media StreamingAuthor / Freelance Writer / IllustratorBnB - Air BNB or Stayz ListingBnB - Other Bed & Breakfast / Hotel / Paid AccommodationBrewing / Distilling / Alcoholic Beverage MfgBrothel / Prostitution / Adult ServicesChildcare Service (Gov. Approved and Licensed)Consultancy / Business ManagementComputer ConsultantDesign Service (Graphic, Fashion, Jewellery, Textile, Commercial Art)Digital MarketingDoctor / Dentist Room(s)Dog Grooming / Pet Walking or Pet SittingFarmingFinancial Planning / Asset ManagementFinance Broking / Mortgage BrokingFood Services (Baking, Cooking, Producing)Food Truck / Food Cart / Coffee Cart / Food Market - No cooking or food preparation at the homeFreelance Artist / PerformerHairdressing / Beauty Services / BarberHobby Farming (No Income Producing)HomeopathIndustry / Trade / Business AssociationInsurance Broker / Agent / AR ServiceInternet Blogging or Social Media InfluencerIroning ServiceJewellery Making or RetailingLegal Service / Lawyer / SolicitorMarriage CelebrantMechanic / Smash Repair / Second Hand Part DealingMusician / Music Publishing or RecordingNutritionist / DieticianPersonal Fitness Trainer (Excl Gym Centres)Photographer / Photography ServicesPhysiotherapist / ChiropractorPlace of Worship / Church / SynagogueProfessional Beauty Services (sole operator)Psychologist / Counsellor / Marriage Guidance ServiceReal Estate Agent / Conveyancing ServiceReflexology / Aroma TherapistTravel Agency ServicesTutoring Service (Academic / Music / Art)Vetinary ServicesWebsite / Software DesignWedding / Party Planner Other Do you have separate insurance in place for these business activities? YesNo Who is the insurer for your Business Insurance? Is the property currently under renovation or do you intend to renovate in the next 12 months? YesNo Is the property in poor condition or poorly maintained? YesNo Is the property under any heritage listing or National Trust listing or order? YesNo Is the property used as a hostel, traditional bed and breakfast, or guesthouse? YesNo Is the property located on a Farm or Acreage? YesNo Do you earn more than $50,000 per year from Farming or Agistment Activities YesNo Land size in Acres For hectares, please list ha after the number (ex 5ha = 12.35 acres) Do you or your tenant have any farm animals on your property? YesNo All farm animals should be declared, whether owned by you or agisting on your property. What type of Farm Animals do you or your tenant have on your property? (List all) Farm Buildings, Improvements and Contents These items are separate from the home building listed below. Farm use Mobile Machinery These are not considered home contents and should be listed separately. Building Basics and Counts Year First Built (Excluding Renovations) If unsure, use the midpoint of the decade you think is most likely. Year last rewired Year last Replumbed Year last Re-Roofed Number of Levels (Excl Underground) Number of Basement or Below Ground Levels Is the building Standard QualityAbove Average QualityTop of the range quality Is the property heritage listed? YesNo How many buildings on site? If you have a granny flat or detached garage, count them separately. Building Type Free standing homeTownhouseTerraceApartment/Unit/FlatFixed / Onsite CaravanPortable CaravanSemi-DetachedDuplex/Triplex/QuadplexGranny FlatNursing Home UnitCabinOther Other building type Is the property part of a strata plan? YesNo If known, please list the Strata Number What material are your external walls made from? (Select all that apply) Brick VeneerDouble Brick or Concrete BlocksStoneConcrete Tilt SlabTimber / Wood / WeatherboardConcreteCement Rendered FinishHardie Plank (Cement Boards made to look like Timber)Fibre CementWeathertexAluminium (Not ACP)Colourbond, Zincalume or SteelVinyl CladdingMudbrickAluminium Composite Panel (ACP)Other Sandwich Panel or Structural Insulated Panel (SIP) SystemStrawOther What material is your external roof made from? (Select all that apply) Concrete TilesTerracotta TilesSlate TilesConcrete SlabColourbond / Zincalume / SteelCorrugated IronAluminiumMetal (Im not sure what type of metal)AsbestosGlassFibroThatchDecraBond / Stonechip / Pressed Metal TilesOther What type of Structural Flooring do you have? (Select all that apply) Concrete Ground LevelConcrete Upper Level(s)Timber Ground LevelTimber Upper Level(s)I am not sureOther Does the property contain any asbestos? YesNo Please provide details 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 (notifies my mobile phone) Keycard or Swipecard access? YesNo Do you have CCTV? YesNo Any other security details Is your CCTV A doorbell video camera onlyExternal Cameras OnlyInternal Cameras OnlyExternal and Internal CamerasMonitored by an external security company 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 townhouseYes, my building is a houseYes, my building is an apartmentNo, I only need contents insuranceNot sure How many units are there in total in your building? Building Replacement Value Preferred Building Excess - select up to 3 $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$10,000Other Contents - Do you want to include cover for your fixtures, fittings, and furnishings at the premise? —Please choose an option—Yes, I require cover for my landlord's contents, fixtures and fittingsNo, building cover onlyNot sure Landlord's contents can include carpets, curtains, blinds, appliances, and fixtures that are not part of the building. Have you fully furnished the property for the tenant's use? YesNo Contents Replacement Value Preferred Contents Excess - select up to 3 $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$10,000Other Would you like your policy to include cover for Landlord's Legal Liability (Public Liability) YesNo Limit of Liability Cover —Please choose an option—$10,000,000.00$20,000,000.00$30,000,000.00 Flood Damage YesNo Accidental Damage YesNo Loss of Rent following damage to the Building or Contents YesNo Do you want to include cover for your tenant defaulting on their rental payments YesNo Often called Rent Default. Available only under Landlords Insurance. Not available on Home Building or Contents Policy. Not available on Short Term Rentals. 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. You will be required to check similar questions 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 that we send to you each 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 otherwise insured 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 Financial Service Guide (FSG) Our Financial Service Guide 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 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. 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. If you are not satisfied with a decision by the IDRC, the matter may be referred to the Australian Financial Complaints Authority if eligible. 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 I acknowledge my understanding of their content. The above statements are true. If any information changes between the date of this Application and the inception date of the insurance, I will notify you immediately. 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, I declare that the individual has been or will be made aware of that fact. I confirm that I am authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy issued pursuant to this Application and I complete this Application on their behalf. Details of Person Completing this proposal form First Name Last Name Signature Previous Next
