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Meet the criteria?YesNo

Type of insuredIndividualBusiness

In the last 5 years has any insured had an insurance policy declined or cancelled by the insurer?YesNo

In the last 5 years has any insured had a claim declined?YesNo

In the last 5 years has any insured had any criminal conviction relating to fraud, theft, dishonesty, arson, or malicious damage (excluding any convictions that are not legally required to be disclosed)?YesNo

Are you aware of any existing circumstances that may lead to a claim under this policy?YesNo

Building typePlease selectFree standing homeApartment or UnitSemi detached homeOther dwelling typeMultiple units or dwellings

Insured Address

What is the occupancy type of the home?Please selectLong term or permanent residencyShort term tenancyShort term tenancy and Holiday HomeShort-term tenancy means the property is leased/rented for a period of less than 3 months. This includes AirBnB.

Is the property currently occupied?YesNo

Is the property furnished?YesNo

Is the property poorly maintained or in poor condition (for example not secure, waterproof or structurally sound)?YesNo

Is the property currently, or scheduled to start construction/renovation within this period of insurance?YesNo

Is the building secure?YesNo

Is there a contract works policy in place?YesNo

Is there an opening in the external roof or walls?YesNo

Can rain and weather get into the building?YesNo

Is the property used as a hotel, motel, serviced apartment, boarding house, shared accommodation, guesthouse, bed and breakfast, homestay, hostel or display home?YesNo

Other than the occupancy use already disclosed to us (long-term or short-term residential tenancy), are any of the insureds aware of any business or commercial activity (including but not limited to hosting weddings or other functions, farming, agistment, or the storage of goods or equipment) at the property?Please selectNoWork from home (as an employee)Home office only (no regular commercial visitors)Used to host weddings or other functionsFarming, agistment or any other income producing agri-businessAny other business activityHint: This includes all buildings and land on the title of the property.

If relevant, please insert any other interested party

Has the insured made any landlord buildings or contents claims in the last 3 years?YesNo