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Heavy Motor Quotes
We do not burden our brokers with special Questionnaires or Quote Forms.
If your slip is missing any information we require, we’ll ask for it after examining your slip.
If you choose to send us a copy of a Questionnaire you have completed in order to get a quote on the same account from a different underwriter, we are happy to work from a copy of that questionnaire. This is particularly beneficial to our brokers in regard to fleets, where some of our competitors have ”War & Peace’’ questionnaires, and pedantically insist on getting their particular form submitted to them, even though the information is basically the same as other companies questionnaires, that you have had to fill in for the same client.
However, to assist you in ensuring you give us all necessary information in one go, we have set out below our basic information requirements. We may ask for additional information on particular accounts.
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Registered Broking Name |
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Brokers Address |
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Placing Brokers Name & Contact Details |
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Insured’s Name including Trading Name, including for each individual subsidiary company |
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Depot/s address/es |
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Other name/s the proposed Insured or any of its Owners or Directors has traded under in the last 10 years, in this or similar occupation/s |
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Has the proposed Insured:
- Ever had an insurance policy declined, cancelled, renewal refused or special conditions imposed?
- Ever had an insurance claim refused?
- Any physical or mental defects or infirmity?
- Other than those excluded from disclosure by law, been convicted of a criminal offence during the last 10 years as an adult, or during the last 5 years as a juvenile?
- In the last 10 years, they or any business they were or associated in, been bankrupt, in liquidation, entered in to a scheme of arrangement, or had a default judgment entered against them?
- Where the insured is an individual/s, in the last 5 years had any driving offences or traffic infringements (other than parking)?
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Full description of business, including types of goods carried |
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How long the business has been trading |
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Claims History - For each of the last 5 years, including the current insurance year, advise:
- Insurers Name
- Insurance Claims
- Basic Excesses
- Fleet size
- Basis of Rating e.g., Aggregate Excess (state amount of Aggregate Excess), Burning Cost, Flat premium etc |
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Current Policy Due Date |
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Holding Broker |
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Vehicle Description including:
- Year
- Make
- Model
- Body Type
- Configuration eg B Double, B Triple, Road Train
- Registered Number or other ID if Unregistered
- Whether Registered or Unregistered
- Carrying Capacity
- Radius of Operation & Base operated from
- Registered Owner
- Any modifications
- Any non standard accessories
- Sum Insured, excluding GST.
- Goods carried
- Dangerous Goods Sum Insured & type of Dangerous Goods carried
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Type of Cover (Comprehensive or Liability Only) |
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Details of any driver aged under 25 years. |
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Non Owned Trailer in Control cover required? If Yes:
- Full description of the circumstances that are causing such trailers to be in your control
- Full description of trailers hauled, including the superstructure eg Stock trailer, Refrigerated Pan. trailer, Non Refrigerated Tautliner trailer, Chiller Tautliner trailer, Side Tipping trailer etc
- Sum Insured (excl GST) for each trailer (separate Sums Insd for B Double A & B trailers)
- Owner of the trailer/s
- Goods hauled on the trailer/s
- Incidence of hauling such trailers, including number of trailers being hauled at any one time
- Radius.
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