Online quote form START YOUR QUOTE Public Liability Quote NZ Levels of cover How much public liability cover do you require?Please select... $1 million $2 million $5 million $10 million $20 million Would you like to include a quote for contents and stock insurance?YesNo How much cover do you require for your contents (excluding stock)? How much cover do you require for your stock? Would you like to include a quote for income protection insurance?YesNo Would you like to include a quote for commercial vehicle insurance?YesNo Tell us about your business What type of business do you operate?Please select... Trade / Service Professional Services Retail Store Wholesale Business Restaurant / Cafe / Bar Importer / Manufacturer Other What is your trade or occupation?Please select... Air Conditioning Boilermaker Bricklayer Builder Cabinet Maker Carpenter Cleaner Electrician Gardender Handyman Joiner Labourer Landscaper Mechanic Painter Panelbeater Pest Controller Plasterer Plumber Plumber & Gasfitter Refrigeration Mechanic Rigger Scaffolder Stonemason Tiler Other Please provide a brief description of your business How long have you been in this occupation / industryPlease select... Up to 1 year 1 to 2 years 2 to 5 years More than 5 years What is the current (or intended) structure of your business?Sole TraderPartnershipCompanyOther What is the annual revenue of your business? (if a new business, provide an estimate) Do you employ any staff?YesNo How many staff do you employ?Please select... 1 2 3 4 5 - 10 10 - 50 50 + Tell us about your business location These questions relate to the premises where your contents and/or stock will be held. In what year were the premises built? If unsure, provide an estimate. Which of the following fire protection systems are in place? (tick all which apply)Smoke heat detector - LocalSmoke heat detector - MonitoredFire extinguisherSprinkler systemAll of the above Which of the following security systems are in place? (tick all which apply)Local alarmMonitored alarmSecurity camera Street Address Suburb Postcode Tell us about your vehicle YearPlease select... 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 MakePlease select... Audi BMW Chrysler Citroen Daewoo Fiat Ford Great Wall Hino Holden Honda Hummer Hyundai Isuzu Iveco Jaguar Jeep Kia Land Rover Lexus Mazda Mercedes Benz Mitsubishi Nissan Peugeot Porsche Proton Renault Seat Skoda Smart Ssangyong Subaru Suzuki Toyota Volkswagen Volvo Model Badge (i.e. SR5, Workmate etc.) TransmissionManualAuto Cylinders468Other Engine size (cc)Please select... 1,000cc 1,100cc 1,200cc 1,300cc 1,400cc 1,500cc 1,600cc 1,700cc 1,800cc 1,900cc 2,000cc 2,100cc 2,200cc 2,300cc 2,400cc 2,500cc 2,600cc 2,700cc 2,800cc 2,900cc 3,000cc 3,100cc 3,200cc 3,300cc 3,400cc 3,500cc 3,600cc 3,700cc 3,800cc 3,900cc 4,000cc 4,100cc 4,200cc 4,300cc 4,400cc 4,500cc 4,600cc 4,700cc 4,800cc 4,900cc 5,000cc 5,100cc 5,200cc 5,300cc 5,400cc 5,500cc 5,600cc 5,700cc 5,800cc 5,900cc 6,000cc 6,100cc 6,200cc 6,300cc 6,400cc 6,500cc 6,600cc 6,700cc 6,800cc 6,900cc Other Is the vehicle alarmed?NoYes What amount would you like to insure the vehicle for? Have you had any at-fault claims or incidents in the last 10 years?NoYes Please provide details Have you had your licence suspended or cancelled in the last 10 years?NoYes Please provide details Tell us about yourself This information is only required for your income protection quote. GenderMaleFemale Date of Birth Do you smoke, or have you smoked within the last 12 months?NoYes Do you have any health issues?NoYes Please provide a brief description of your health issue/s. TIP: Do not enter the '$' symbol or any other text, enter numbers only. What is your personal taxable income? The insurer will allow you to cover up to 75% of your income. Based on the annual income you entered above, the maximum monthly benefit to you will be: Is this the amount you would like to insure yourself for?Yes, I need this much coverNo, I would like to insure myself for a different amount What is the monthly amount you would like to cover yourself for? If you could not work, how long would you like your monthly benefits to continue for? For 2 yearsUntil I reach age 65I'm not sure, please quote me on both If you could not work, how long would you be willing to go before you started receiving benefits from your policy? Note: The shorter the timeframe, the more expensive the premium will be.14 days30 days (most common)60 days Underwriting Questions Does the business undertake work at airports, railway stations, oilrigs, gas rigs, oil refineries, chemical refineries, mines, quarries, shipyards or mainframe computer installations?NoYes Please provide details Do you employ Sub Contractors or use Hire Labour accounting for more than 25% of your total turnover?NoYes Please advise what dollar amount of your turnover relates to work contracted out to labour hire or sub-contractors: Does the business engage hired labourers or contractors on any one project where value of all such work on the project is greater than $20,000?NoYes Please provide details: Have you or your business partners: Suffered any losses (insured or otherwise) totalling more than $5,000 in the last 12 months or $10,000 in the last 3 years, or suffered 2 or more claims in any one policy year?NoYes Please provide details of each loss or claim, including the approximate date and the dollar amount lost or claimed. In the last 5 years, had any insurer decline any claim or proposal, cancel or refuse to renew a policy, or increase premium or impose special conditions?NoYes Please provide details: In the last 5 years been placed in receivership or liquidation or declared bankrupt? NoYes Please provide details: In the last 10 years been convicted of or had any fines or penalties imposed for any crime involving drugs, dishonesty, arson, theft, fraud or violence against any person or property? NoYes Please provide details: Tell us about your existing cover This information will help us to provide you with the most competitive quote Do you currently hold public liability insurance?YesNo How much are you covered for?Please select... $5,000,000 $10,000,000 $20,000,000 Other Who is the insurer? What is the premium? Why not?Please select... Newly established business Previously uninsured Other Other Contact Details Your quotes will be generated and issued by a real person, not by a computer. If our staff suspect your name, phone number or email address is not genuine we will not process your quote request. Is this quote you or for someone else?MeSomeone Else Enter your name here, and the name of the person to be covered below. First name Surname Business name Phone number Email address Street address Your suburb Postcode How did you find us?Please select... Google search Yahoo Search Referred from an existing client I am an existing client Word of mouth Other Other How would you like to receive your quotes?Please select... Email Phone Do you have a preferred contact time?Please select... Anytime Before 9am During the day After 5pm Need assistance with this form?
