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This will give us all the information we need to provide a quote. If we require further information from you, we will contact you as soon as possible.
When arranging a Business Insurance policy you must tell us everything you know (or could be reasonably expected to know) that a prudent insurer would want to take into account in deciding:
Examples of what you must tell us include:
You must also tell us this every time you seek to renew your policy, when you make any changes to it, or if your situation changes.
Failure to disclose information material to the risk may prejudice your policy.
When in doubt, disclose. We treat all informaiton confidentially.
If you would like to also arrange the direct debit for this Business Insurance quote, please complete the direct debit authority here.
If different from above. Please include street, suburb and postcode
Please note we are unable to issue an insurance policy for a past date. If you require insurance to start in the next three business days, please call us on 0800 800 627.
Please tick all cover options you require.
If you selected Building cover and/or Contents cover from the above list of cover required, please complete the questions below. Otherwise, skip to the next section.
Please tick all valid options.
Maximum 5 files (JPG, PNG or PDF); up to 20 MB per file.
Indemnity Value and Market Value are used to calculate Fire and Emergency Levies.
Please provide the annual rent amount.
Please include the value of portable items.
For example, kept in vehicle or removed to be stored at home or business premises.
For example, parked in the street, driveway, garage.
Please tick all the months cover is required.
Standard cover is $5,000. If an increase is required, please ensure you specify the total amount of refrigerated stock cover required.
Please include a website link if possible.
Standard cover is $5,000. If an increase is required, please ensure you specify the total amount of Money cover required.
One of our Business Risk Advisers will contact you to assess the appropriate sum insured for your Business interruption cover.
Standard cover is $10,000. If an increase is required, please ensure you specify the total amount of book debts cover required.
Please complete the following details in respect of the insured entity.
Standard cover is $2,000,000. If an increase is required, please ensure you specify the total amount of legal liability cover required.
Standard cover is $1,000,000. If an increase is required, please ensure you specify the total amount of statutory liability cover required.
Standard cover is $500,000.
Standard cover is $25,000.
Standard cover is $500,000
The information sought by this question is subject to the rights set out in the Criminal Records (Clean Slate) Act 2004.
Regardless of whether an insurance claim was made.
I understand that I have a duty to disclose all information that Medical Insurance Society Limited (MAS) may want to take into account in deciding whether or not to accept my application and if so, what terms. I confirm that:
I understand that if I have not disclosed all relevant information that I know, MAS may decline a claim I make under this policy, cancel the policy or treat the insurance as being invalid from the beginning.
Medical Insurance Society Limited has a Financial Strength Rating of A from approved rating agency S&P Global Ratings Australia Pty Ltd and this reflects our ability to pay claims.
I understand that:
I authorise MAS to give or obtain personal information about me (relevant to my insurance) to or from others including but not limited to the Insurance Claims Register Limited.