Landlord Insurance Provider | Arcadia Insurance

COVER QUALIFYING CRITERIA

Property is used for

Residential Rental Commercial Rental

There is a written lease in place and condition report completed annually.

Yes No

PROPERTY MANAGMENT DETAILS

Property Managers Name

Real Estate Agency Office

Contact Phone Number

Your Email

PROPERTY OWNER (LANDLORD) DETAILS

Surname

Given Name

Date of Birth

Mobile Ph

Work Ph

Company Name (if applicable)

ABN (if applicable)

Address (please provide postal address, if different from street address)

Suburb

State

Postcode

PROPERTY POLICY DETAILS

Please provide details of the property you are insuring

Address (please provide postal address, if different from street address)

Suburb

State

Postcode

Weekly Rent Amount

MORTGAGE PROVIDER

Please specify mortgage provider: (to be noted as an interested party on the Certificate of Insurance)

INSURANCE REQUIREMENTS

PROPERTY TYPE

Apartment House Townhouse

Do you require a quote for your building insurance?

Yes No

Total Building Sum Insured

Property Walls

Brick Double Brick Weather Board Other

Locks on window and doors

Yes No

Alarm

Local Monitored No Alarm

Year of Build

Pet Cover

Yes No

Insurance Start Date: (cannot be backdated or more than 30 days in advance)

POLICY HOLDER DISCLOSURE

Has anyone to be named insured had a claim refused or declined for fraud or dishonesty ?

Yes No

In the last 5 years, has anyone to be named insured been declared bankrupt, or entered into a part 9 debt agreement whether voluntary or not, or had any other default judgment registered against them ?

Yes No

In the last 5 years, has anyone to be named insured had any criminal convictions ?

Yes No

DECLARATION & PAYMENT DETAILS

You will receive a Certificate of Insurance and Invoice which states our payment details, in order for you to deposit the premium amount. If being completed by a Property Manager, the Property Manager has authorisation from the owner/s to arrange this Insurance Policy on his/her behalf for the above rental property.

I have read and understood the policy terms and conditions

Yes

Authorised person’s full name:

Authorised person’s signature

Date

LANDLORD insurance Application Form

Arcadia Insurance Quote

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