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SSAA General Insurance Brokers arrange all types of home insurance with coverage obtained from Australia’s leading insurance companies.

Home Insurance

Our insurance products are selected from the major insurance companies and can include cover for:

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    Insured details applicant 1

    First name*

    Surname*

    Date of Birth*

    Home phone

    Work phone

    Mobile phone*

    Email address*

    Over 55 & Retired?*
    YesNo

    Preferred Method of Contact?*
    EmailPhoneFax

    SSAA membership number (if applicable)

    Insured details applicant 2

    First name

    Surname

    Date of birth

    Policy Cover

    Current insurer*

    Expiry date*

    Current excess

    Current premium (optional)

    Occupancy?*
    Owner OccupiedApplicant is tenantApplicant is landlordHoliday homeUnoccupied

    Type of Cover?*
    HouseholdLandlords

    Landlords

    Loss of rent (weekly)

    Rent default and theft by tenant?
    YesNo

    Is the property managed by a licensed property agent?
    YesNo

    Insured Property Details

    Property Address

    Address*

    Suburb/town*

    State*

    Postcode*

    Postal Address

    Postal address same as property address

    Address

    Suburb/town

    State

    Postcode

    Other

    Dwelling Type*

    If Other, please specify Dwelling Type

    Construction of building*

    If Other, please specify Construction Type

    Roof*

    If Other, please specify Roof Type

    Is the building…*

    Year Built*

    Sum insured

    Part 1

    Building (replacement value*)

    Contents (replacement value*)

    Part 2

    Specified valuables (covered when outside the home property – items exceeding $10,000)

     
    Description
    Value

    1.

    2.

    3.

    4.

    5.

    6.

    7.

    Security details

    Deadlocks on all external doors?*
    YesNo

    Keyed window locks on all windows?*
    YesNo

    Back to base alarm?*
    YesNo

    Local alarm system?*
    YesNo

    Is the property used for business?*
    YesNo

    If Yes, what type of business?

    Is the property attached to mains water?*
    YesNo

    Safe?*
    YesNo

    Gun safe?*
    YesNo

    Bars or grills on all accessible windows?*
    YesNo

    Is the property on more than 4 acres?*
    YesNo

    Will the property be unoccupied for more than 60 days in the next 12 months?*
    YesNo

    Insurance history

    Has any applicant been declared bankrupt and not discharged for at least one year?*
    YesNo

    If Yes, please supply details

    During the last 5 years has any applicant had any type of loss or damage (whether claimed or not)?*
    YesNo

    If Yes, please supply details

    Is the property to be insured attributable to flood?*
    YesNo

    During the past 5 years has any applicant had any:

    (a) Application for insurance rejected?*
    YesNo

    If Yes, please supply details

    (b) Policy cancelled by an insurance company?*
    YesNo

    If Yes, please supply details

    (c) Special conditions set for your policy?*
    YesNo

    If Yes, please supply details

    (d) Renewal of insurance policy not offered?
    YesNo

    If Yes, please supply details

    (e) Increase excess imposed on your policy?*
    YesNo

    If Yes, please supply details

    During the last 10 years has any applicant had any criminal conviction relating to drugs, dishonesty, arson, theft, fraud or violence against any person or property?*
    YesNo

    If Yes, please supply details

    By submitting this form you certify that you have read and agree to the Duty of Disclosure. (View)

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    Disclaimer

    The information provided by SSAA General Insurance Brokers Pty Ltd on this website is for general information purposes only, and it is not a substitute for professional advice. You should always consider the PDS/Policy wording before making a decision.

    Coverage may differ based on specific clauses in individual policies. Refer to the FSG on our website or by requesting a copy for our services and remuneration details.