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Strata Insurance Proposal Form

    1

    Your Details

    2

    About your Strata Plan

    3

    Insured Property Details

    4

    Cover Required

    5

    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.

    Your Contact Details

    What is your relationship to the Strata Plan? *

    Next, tell us about your Strata Plan

    Upload or drag files here.
    This isn’t compulsory - However, the more information you can provide to us, the better results we can obtain for you.
    This isn’t compulsory - However, the more information you can provide to us, the better results we can obtain for you.
    Upload or drag files here.
    This isn’t compulsory – however, the more information you can provide to us, the better results we can obtain for you.

    What is the full address of the Property to be Insured? *

    Building Age & Levels

    How is your property occupied?

    (Select all that apply)

    About the Insured Location

    Building Facilities

    Construction Information

    (Select all that apply)
    (Select all that apply)
    (Select all that apply)
    For more information on Sandwich Panels, please visit – Chubb risk bulletin – aluminium composite panels

    Fire Protection

    Cladding Materials

    Further Details

    Sums Insured

    What is your preferred excess / deductible?

    You can elect a higher excess for a lower premium or a lower excess for a higher premium

    If you would like a different excess for Water Damage claims, please list this here

    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 that we send to you each and every year to ensure the answers remain accurate and notify us of any changes that are required.

    The Insurance History for your Strata Plan

    In the past five years has any insurer:

    Claims History last 5 years

    Unreported Claims or Damage

    Please list any damage or claimable circumstances that have not yet been reported to your current insurer

    Duty to not misrepresent

    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 14 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 the Australian Financial Complaints Authority (AFCA) 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.

    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.

    Insert and format text, links, and images here.

    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/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 form