Quick Quote - Vacant Land Liability Insurance

For an indicative quote, please complete and submit the form below.

For a more accurate quotation, please download, complete and return the Proposal Form.

 

Broker Details

 
     
Tick this box if you are an insurance broker
 
yes I am an insurance broker
Your Name
 
Broker Name
 
Branch / Location  
Your Email
 
Your Phone
 
 

Insured's Details

 
     
Full Name of Insured
 
Situation
(Address, State and Postcode)
 
Inception Date    
     
Limit Required
 
$5,000,000
$10,000,000
$20,000,000
$50,000,000
 

Land Details

 
     
Size of Land
 
SQM
     
Are there any dams or watercourses on this land?
 
yes no
If yes, please provide details
 
     
Is land fenced?
 
yes no
     
Are there any buildings or structures on this land?
 
yes no
If yes, please provide details
 
     
Is the Land Used for Agistment Purposes?
 
yes no
     
Claims details - summary last 10 years
 
 
Ever been declined insurance?
 
yes no
Comments
 
 
 
PLEASE NOTE
This is for the use of NON BINDING INDICATIVE QUOTATION PURPOSES ONLY and is subject to a satisfactorily completed Proposal Form Prior to Binding
 
 


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