On-line Caravan Insurance


Thank you for considering our on-line caravan insurance service.   Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right caravan insurance for you.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deal that fits your requirements.
1a. Is this a new purchase?
Yes No
1b. If no has it previously been insured?
Yes No
If yes, please provide the name of the insurer:
Caravan and Annexe Details:
(Only answer questions relevant to your caravan - otherwise leave fields blank)
2a. Caravan - Make:
2b. Caravan - Model:
2c. Caravan - Year of Manufacture:
2d. Caravan - Registered No.:
2e. Caravan - Length:  metres
2f. Caravan - Width:  metres
2g. Caravan - Number of Berths:
2h. Caravan - Date purchased:
2i. Caravan - Current Estimated Value: $ 
2j. Caravan - Purpose of Use (ie. Private, Business, Hire):
3a. Annexe - Make:
3b. Annexe - Year of Manufacture:
3c. Annexe - Made out of:
Canvas Vinyl Aluminium Solid Walls
3d. Annexe - Current Estimated Value: $ 
3e. Annexe - Year of Manufacture:
4. Contents Cover - Item Description & Sum Insured (Please list items worth over $500 that you want covered):
$ 
$ 
$ 
5. Do you owe money on this Caravan?
Yes No
6. Is your caravan roadworthy, in working order, free from mechanical defects and in an undamaged condition?
Yes No
If No provide details:
7. Has your caravan been modified or fitted with accessories?
Yes No
If Yes provide details:
8. What kind of cover do you want?
On Site Only Australia Wide
9a. Postcode where your caravan is usually kept:
9b. Is the caravan permanently "on site"?
Yes No
If Yes what is the location?
Applicant Details:
10a. Date of birth of applicant (DD/MM/YYYY):
10b. Percentage of use: %
10c. Occupation of applicant:
10d. How long has the applicant held a licence?  years
10e. Are you entitled to a No Claim Bonus with your current insurer?
Yes No
If yes, please specify what rating:
10f. If you hold rating 1, how many years has it been since your last claim (enter 99 if you have never claimed):
11. For each other person who will use, tow or carry your caravan:
Date of birth of applicant 2 (DD/MM/YYYY):
 Percentage of use: %
How long has the applicant held a licence?  years
Date of birth of applicant 3 (DD/MM/YYYY):
 Percentage of use: %
How long has the applicant held a licence?  years
Have any of the applicants (Note you must answer these questions):
12. Been charged with, or convicted of, or penalised for any motoring offences or had a driving licence suspended, cancelled or restricted by endorsement?
Yes No
Details:
13. Ever had any insurances refused or cancelled?
Yes No
Details:
14. Been charged or convicted of any offense in the last ten years?
Yes No
Details:
15. Been involved in a car or caravan accident, had a car or caravan burnt or stolen, or claimed against an insurance company for daage to a car or caravan, in the past 5 years?
Yes No
Details:


Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are 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 form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address:
Country: