On-line Contractors Public and Products Liability Insurance


Thank you for considering our on-line contractors public and products liability 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 contractors public and products liability insurancefor 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.


Limit of Liability Required:
1a. Please select the amount of Liability cover required:
$5,000,000 $10,000,000 $15,000,000 $20,000,000
1b.
Public Liability (any one occurrence)
Products Liability (each Period of Insurance)
2. Do you currently have Public Liability insurance?
Yes No
If Yes, please provide details below:
Expiry Date
Insurance Company
Indemnity limit $
Excess $
Premium $
Business Details:
3. Full description of the occupation:
4. Area/Location:
5. Number of years in this business under this name:
6. Previous industry experience if less than five years in business:
7. Are you represented outside Australia?
Yes No
If Yes, please provide details:
8. Details of all claims or incidents in the past 5 years (incl. Contributing deductibles):
9. Existing deductible: $
10. Estimated annual Turnover, split by occupation, if applicable:
11. Estimated annual wages: $
12. Are Labour Hire personnel engaged by the Insured under a Contract of Service?
Yes No
If Yes, please advise estimated payments to such personnel and the activities performed:
13. Do hired personnel work under the supervision of the Insured or that of the provider?
Insured Provider
14. Are Contractors or Sub Contractors engaged by the Insured?
Yes No
If Yes, please advise estimated payments to such personnel and the activities performed:
15. Estimated percentage of payroll split between work at and away from your own premises:
At premises: % $
Away from premises: % $
16. Is work performed away from your premises?
Yes No
If Yes, please provide details of such work, including duties undertaken, sites worked on and estimated % of turnover derived from such work:
17. Is any work performed on the following sites:
% of turnover derived from work on site
Underground sites
Mine sites
Airfields/Airports
Oil or gas production facilities
Chemical works
Wharves/Docks
Security sensitive sites
If any of the sites have been selected, please provide a full description of work performed:
18. Do you agree to indemnify or hold harmless any other parties, by written agreement or otherwise?
Yes No
19. Limit of Indemnity: $
20. Does the Insured operate to relevant Australian Standards for the industry involved?
Yes