On-line General Equipment Insurance

musical instruments - photographic equipment - computer equipment - other equipment



Thank you for considering our on-line general equipment 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 musical instruments / photographic / computer equipment 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 deals that fit your requirements.

1a. Description of items to be insured, including value of insurance required:
Please specify which currency you are using (US$, AUS$ etc.)
1b. Period of insurance required: From    To 
1c. Geographical boundaries of insurance:
Australia Wide World Wide
1d. Situation where the equipment is usually kept overnight:
Security Details:
1e. Local burglar alarm
Yes No
Back to base burglar alarm
Yes No
Deadlocks on external doors
Yes No
Windows barred or keylocked
Yes No
Other
Has the proposer, or any other person for whom this insurance will apply:
2a. Suffered any loss during the past 5 years from any events that you wish to insure for?
Yes No
2b. Been refused insurance?
Yes No
2c. Been quoted an increased premium?
Yes No
2d. Had special terms imposed?
Yes No
2e. Been charged or convicted of any offense involving dishonesty of any kind?
Yes No
If any of the above questions have been answered 'yes' please provide 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: