On-line Strata Insurance

Thank you for considering our on-line strata 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 strata 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.

About the property you wish to insure:
1a. What is the address of the property you wish to insure?
Strata Plan Number:
1b. Post Code
1c. What is the construction of the walls?
1d. What is the construction of the roof?
1e. What is the number of stories (other than ground floor)?
1f. Age of building: Years
1g. How many lifts and/or escalator and/or hoists are there?
1h. How many swimming pools and/or spas are there?
1i. Are there any other recreational facilities other than swimming pools and / or spas?
No Yes
If Yes, what are they?
1j. Are any parts of the buildings used for any purpose other than residential?
No Yes
If Yes, describe what that part is used for:
1k. Are the buildings managed by an authorised strata manager or strata management company?
No Yes
If Yes, what is the name of the person or company?
Buildings and Common Property:
2a. What is the replacement cost of your building? $
2b. How many units are to be insured?
2c. Are the buildings residential or commercial?
Residential Commercial
3. Please select the the amount of Liability cover required:
$5,000,000 $10,000,000 $15,000,000 $20,000,000
Fidelity Guarantee:
4. What is the amount of Fidelity cover required? $
Office Bearers Liability:
5. What is the amount of Office Bearers Liability cover required? $
Personal Accident:
Cover is for injury while engaged in administrative or light maintenance duties arranged by the Body Corporate.
6. Do you want cover for Personal Accident?
No Yes
If Yes, how many units of cover do you require?
(Each Unit provides $10,000 C???? benefits or $100 per week)
Workers' Compensation (Available in NT, WA, NSW and Tas. only)
7. Do you want cover for Workers' Compensation for person employed in connection with owning, operating and managing the buildings?
Some circumstances make Workers' Compensation compulsory if you have employees. (If unsure check with your local Workers' Comensation Authority)
No Yes
If Yes, for what amount? $
8. Have any of the applicants suffered any losses or had any claims made against them within the last 5 years, whether claimed or not?
No Yes
If Yes, complete the following details:
Type of loss or claim Date    Amount Name of insurer (if applicable)
9. Have any of the applicants or any person who will receive insurance cover under the proposed policy, been charged with or convicted of any criminal offenses during the last 10 years?
No Yes
If Yes, provide details:
Please answer questions 10 to 12 only if cover for Fidelity Guarantee or Office Bearers Liability is required.
10. How many people are members of the council or committee or governing body of the committee?
11. Of these people, how many are owners of a unit/lot or flat?
12. Is a member aware of claims made or circumstances which may result in claims being made against them or their predecessors in their capacity as members of the committee or the governing body?
No Yes
If Yes, provide the changes:
Please answer questions 13 to 16 only if cover Workers' Compensation is required.
13. Do you employ a caretaker?
Yes No
If Yes, state the estimated annual salary or wages: $
14. Do you employ any other persons in connection with the building?
Yes No
If Yes, state their
Occupation   Estimated annual salary or wages
15. Do you employ any other persons in connection with any other trade or business?
Yes No
If Yes, state their occupation(s) / trade(s)
16. Do you have a Workers' Compensation policy for these trade(s) or business(es)?
Yes No
If Yes, state the name of the insurance company and policy number

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:
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: