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Home
About
Services
Physical Asset Insurance
Medical Cover
Life & Disability insurance
Investments
Bespoke financial advice
Media
Contact
Home
About
Services
Physical Asset Insurance
Medical Cover
Life & Disability insurance
Investments
Bespoke financial advice
Media
Contact
Menu
Home
About
Services
Physical Asset Insurance
Medical Cover
Life & Disability insurance
Investments
Bespoke financial advice
Media
Contact
Home Contents Insurance
Capture your details and we’ll get an expert to respond with some options and guidance for you.
A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.
Would you like to attach your existing policy? (If you attach an existing policy you can reduce the amount of information we need to capture.)
Please select…
Yes
No
Please attach your current policy schedule
Please attach a copy of your ID
Who is your current insurance company?
What is your current policy number?
What is your current insurance premium?
For how many years have you been insured?
Your insurance company prior to current (if any)?
Personal Details
Insured First Name
Insured Surname
Gender
Please select…
Male
Female
Other
Nationality
ID Number
Occupation
Residential Address
Postal Address
Cellphone Number
Email Address
Marital Status
Please select…
Married
Co-Habit
Divorced
Widowed
Single
Are you co-insured? (i.e. another person with an interest in insuring this asset)
Please select…
Yes
No
Co-Insured Name & Surname
Co-Insured Gender
Please select…
Male
Female
Co-Insured ID Number
Co-Insured Occupation
Has an insurance company ever cancelled your entire policy or part of a policy?
Please select…
Yes
No
Has special conditions ever been attached to your Insurance?
Please select…
Yes
No
Claims
Please include detail of any short term claims you've had in the last 5 years
Date of Claim
Type of Claim (Vehicle, Home, Assets, etc)
Description
Amount Paid
Have you had another claim in the last 5 years?
Please select…
Yes
No
Date of Claim
Type of Claim (Vehicle, Home, Assets, etc)
Description
Amount Paid
Have you had another claim in the last 5 years?
Please select…
Yes
No
Date of Claim
Type of Claim (Vehicle, Home, Assets, etc)
Description
Amount Paid
Household Contents
Sum insured (value for which we must insure your contents)
Is this the main residence or holiday house?
Please select…
Main house
Holiday Home
Do you occupy the house as the owner or a tenant?
Please select…
Owner
Tenant
Security information directly related to your home and your immediate property
Alarm: Does your house or flat have an alarm linked to 24 hour manned controlled room with armed response
Yes
No
Burglar bars: On ALL opening windows incl outbuildings & garages
Yes
No
Security gates: On ALL externally opening doors incl outbuildings & garages
Yes
No
Do you have an inter-leading door from your garage to your house
Yes
No
Residence Perimeter fence (wall directly around your home)
Yes - Bricks
Yes - Palisade fence
Yes - Vibacrete
Yes - Wood
No
Electric Fencing: On ALL perimeter walls immediately around your home
Yes
No
Is this fence alarm linked to an manned control room with armed response
Yes
No
Vacant plots immediately adjoining your property
Yes
No
Is your home occupied during the day.
Yes
No
If so, by whom?
Built up area
Yes
No
Is your home within 2 km of an information settlement or township?
Yes
No
Is your home within 500m of a lake, shoreline or dam?
Yes
No
Neighbourhood watch: Does a neighbour hood watch patrol daily & regularly
Yes
No
Description of Home construction
Standard (bricks, tiled or iron roof)
Non-Standard (thatch, timber or pre-fab)
Do you live in a block of flats, gated complex or high security estate?
Please select…
Yes
No
Which type?
Please select…
Block of flats
Gated complex
High security estate
24 hour access control ie guards, security boom, sign in and out Vertical Align Center
Yes
No
24 hour security guard patrols (on foot, by bike or by car)
Yes
No
Armed response for entire complex
Yes
No
On what floor is your unit?
Is there an OUTER Perimeter fence ie around your complex / block of flats
Yes - Bricks
Yes - Palisade fence
Yes - Vibacrete
Yes - Wood
No
is the perimeter wall 1.8m high
Yes
No
is there an electric fence around the complex perimeter wall
Yes
No
Is this fence alarm linked to an manned control room with armed response
Yes
No
Terms and Conditions
By ticking, you are confirming that you have read, understood and agree to
Life Current terms and conditions.
Submit