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Business Insurance Quote Online Form

Please complete the following information and submit this form to obtain an insurance quotation for your business.

Click on one of the following links if you would like to obtain a quote for another type of insurance product.

All information you provide must be correct, true, and accurate as incorrect or misleading information may alter our quote and jeopardise cover if you proceed with a policy.

Please refer to the CGIB Financial Services Guide, Privacy Statement, General Advice Warning and Duty of Disclosure before completing this form.

You have errors in your submission, they are highlighted in red below

INSURED'S Details

Business Name/Insured*
Business Address
Street Name and Number* Post Code* City/Town*

Business Occupation*
Fully describe all the products and/or services your business provides*

Business Website Address

ABN Number

INSURANCE Details

BUSINESS PROPERTY (FIRE & PERILS)

(Loss or Damage at the Business Premises caused by a defined event (such as Fire and Perils) listed in the Insurers PDS/Policy Wording)
Property Cover Required?*

ITEM INSUREDAMOUNT TO BE INSURED
Please enter a value and if not required, enter 0
Building/s* $ info recommendation
Contents* $ info recommendation
Stock and Customer Goods* $ info recommendation
Rewriting of Records* $ info
Removal of Debris* $ info
PREMISES DETAILS
Construction Material of the Walls?*
Construction Material of the Floors?*
Construction Material of the Roof?*
Premises Equipped with a Sprinkler System?* Yes No
Premises Equipped with Fire Hydrant/Hoses?* Yes No
Premises Equipped with Fire Extinguishers?* Yes No
Premises Equipped with Fire Alarm?* Yes No
Premises Connected to Town Water?* Yes No
Sandwich Paneling?* Yes No
Age of Building?*
Building been re-wired / re-plumbed?*
Is the building Heritage Listed?* Yes No
COOKING DETAILS
Does the business activities involve cooking?* Yes No

BURGLARY

(In the event of loss or damage caused by theft - subject to the Insurers PDS/Policy Wording)
Burglary Cover Required?*

ITEM INSURED
Contents* $ info recommendation
Stock and/or Customers Goods* $ info
Stock of Cigs, Tobacco or Liquor* $
PREMISES DETAILS
Premises Equipped with a Security Alarm?*
Premises Equipped with Deadlocks on external doors?* Yes No
Premises Equipped with Key locks &/or Bars on Windows?* Yes No

BUSINESS INTERUPTION

(In the event of interruption of or interference with the business as a direct consequence of damage - subject to the Insurers PDS/Policy Wording)
Business Interruption Cover Required?*
ITEM INSUREDAMOUNT TO BE INSURED
Annual Gross Profit* $ info recommendation
Additional Increase Cost of Working* $ info
Claim Preparation Fees * $ info
Annual Wages* $ info
Annual Rent* $ info
Indemnity Period* info recommendation

GLASS

(In the event of breakage - subject to the Insurers PDS/Policy Wording)
Glass Breakage Cover Required?*
Covering*

MONEY

(In the event of loss or destruction of or damage to the insured property (money) - subject to the Insurers PDS/Policy Wording)
Money Cover Required?*
Maximum Value*

PORTABLE ITEMS

(Covers the insured property anywhere in Australia - subject to the Insurers PDS/Policy Wording)
Portable Items Cover Required?*
At least one of the questions must be answered.
1. Unspecified Tools (all tools with individual item value below $1,000)
2. Specified Tools (tools items with individual item value over $1,000)
3. Laptops & electronic Items (list all items and include each item value)
4. Stock
5. Other (List all items not included above and include each items value$)

TAX INVESTIGATION

(Provide cover for the costs incurred by your accountant or registered tax agent in conducting taxation audits or detailed investigations in relation to your liability to pay a range a taxes- subject to the Insurers PDS/Policy Wording)
Tax Investigation Cover Required?*
Tax Audit Costs up to*

PUBLIC & PRODUCTS LIABILITY

(For amounts you become legally liable to pay as compensation for Personal injury or Property Damage as a direct result of an occurrence happening in connection with your business - subject to the Insurers PDS/Policy Wording)
Liability Cover Required?*
Sum Insured Required*   
Driving Risk $ info
Do you employ sub / contractors*    Yes No
Do you use labour hire*    Yes No
Does the business import &/or export?*   
Is your business licensed to sell alcohol?*    Yes No
Total Number of Staff*    
Annual Business Turnover* $
Do your operations include any of the following?
- work at airports, railway, oilrigs, gas rigs, oil refineries, chemical refineries, mines or quarries, ship yards?* Yes  No
- work with/on cooling towers, alarm systems or mainframe computers?* Yes  No
- boilers and/or compressors which require Government certificates?* Yes  No
- manufacture, distribution, storage, transportation, of chemicals or other toxic or harmful matter?* Yes  No
- use or storage of explosives?* Yes  No
- provide any advice, design or professional services, whether or not a fee is charged for such advice, design or professional service?* Yes  No
- conduct any welding?* Yes  No
If yes to any of the above, please provide details

ELECTRONIC EQUIPMENT BREAKDOWN

(Physical loss or damage to the Insured item. Physical loss or damage to the Insured item caused by mechanical, electrical or electrical failure, malfunction or breakdown - subject to the Insurers PDS/Policy Wording)
EE Breakdown Cover Required?*
Sum Insured* $
Costs to Restore Loss Data* $
Additional Costs Incurred* $

MACHINERY BREAKDOWN

(The event of sudden and unforeseen physical loss of or damage to any item or any part of any item of the property (insured machinery) which necessitates its immediate repair or replacement - subject to the Insurers PDS/Policy Wording)
Machinery Breakdown Cover Required?*
Sum Insured* $
Number of machinery units*    
Food spoilage Sum Insured* $

GOODS IN TRANSIT

(Loss or Damage to goods in transit/transport caused by a defined event (such as Fire and Perils) listed in the Insurers PDS/Policy Wording)
Goods In Transit Cover Required?*
Cover for goods in transit whilst*   
Number of vehicles carrying goods*    
Maximum total value of goods any one transport* $
Annual value of goods transported (estimate next 12 months)* $

PREVIOUS INSURANCE - Details - MUST COMPLETE ALL QUESTIONS

Do you currently hold an insurance policy?*
Please provide the date your existing policy expires*
Please provide the name of the Insurer*
Have you ever suffered any losses or claims?* Yes No
Have you ever had any insurance cancelled or declined or special terms imposed?* Yes No
Have you ever been charged or convicted of any criminal offence or declared bankrupt?* Yes No
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?* Yes No
If yes to any of the above, please provide details

CONTACT Details

First Name*
Surname*
Is Contact Postal Address same as Business Address?* Yes No
Postal Address* Post Code* City/Town*
Phone Number* (please include area code)
Fax Number (please include area code)
Email Address*
How did you find us?*
Comments
* Mandatory Fields
Thank you for completing our online form.
We will endevour to contact you with your insurance details soon.
We may need to contact you to obtain additional information to provide you with an insurance quotation.
Completion of this form does not put an insurance policy/cover in place - you will need to contact us to arrange insurance cover.
All information you provide must be correct, true, and accurate as incorrect or misleading information may alter our quote and jeopardise cover if you proceed with a policy.
We recommend that you read the relevant Product Disclosure Statement when considering an insurance policy.