Prestige Home & Contents

Please complete this online quotation request form.

Client information
Salutation
First Name*
Surname*
Email*
Address*
Suburb*
State*
Postcode*
Country*
Occupation
Employer
Age
Spouse's occupation
Spouse's employer
Spouse's age
Sum insured
Home & contents policy. Note: Special limits apply (per loss) under the contents section, eg: jewellery $50,000 ($25,000 limit per item)
Building (min $500,000) $
Contents (min $150,000) $
Deductible	Please select the amount of excess you want.
Valuable Articles policy (Note: A Valuable Articles profile is required if the jewellery coverage exceeds $100,000)
Jewellery $ Note: If you require a stand along jewellery quote the minimum sum insured is $25,000.
No. of items
Largest item $
Furs $
Fine arts $
Silverware $
Wine $
Other $
Cover extensions
Deluxe Home Business Property cover	Yes No Please indicate if required. (Note: A Home Business quotation sheet will need to be completed if cover required).
Risk Details
Type of residence
Residence status
If holiday home how often visited	Per year
Construction
Roof construction
Age of building	Age in years
Heritage listed	Yes No
Has property been renovated?	Yes No
If renovated, when?
Are renovations planned in the next 12 months?	Yes No
If renovations are planned, what type?
Security
Deadlocks
Keyed window locks
Burglar alarm
Smoke detectors
Safe
Other
Loss history
Has the proposer had any circumstances that occurred in the last five years that could have given rise to a claim under a household insurance policy whether insured or not? If yes, please give details (including dates and amounts paid).
Has the proposer ever been refused insurance (new or renewal), had insurance cancelled or cover rejected? If yes, please give details (including dates and amounts paid).
General information
Present underwriter
Present Base premium $
Due date
Present deductible $
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This does not constitue an offer of cover. A quotation based on the information contained herein will be forwarded to you.

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