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Sunshine Coast 1800 072 114 | Central Queensland 1800 961 007 | North Queensland 1800 629 701

The Steel family established Pacific Insurance Brokers in 1982, opening offices in both the Solomon Islands and Vanuatu.

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BHI Landlord Insurance Application Form

BHI Landlord Insurance Application

Please answer all questions. Blanks and/or dashes, or answers "known to underwriters or brokers" or "N/A" are notacceptable and will delay processing of this application.
Where appropriate, please tick the yes or no box which best indicates your reply.
Your Details
Period of Insurance
Expiry Date
DD slash MM slash YYYY
Acceptance Criteria
Have you been declined insurance in the past 12 months
- Yes
- No
Is the property used for business purposes other than home office or surgery
- Yes
- No
Is the property under construction, reconstruction or renovation
- Yes
- No
Is the property in poor condition or poorly maintained
- Yes
- No
Is the property expected to be unoccupied for more than 90 continuous days during the period of cover
- Yes
- No
Is the property under any heritage listing/National Trust listing or order
- Yes
- No
Is the property used as a hostel, bed and breakfast or guesthouse
- Yes
- No
Insured
Insured Name
What is the date of birth of the oldest insured
DD slash MM slash YYYY
Phone
Email
General Details
Current insurer
Coverage
Occupancy Type
- Rented to Tenants (long term basis)
- Rented to Tenants (shortterm basis)
- Owner Occupied and rented to Tenants (short term basis)
- Weekender / Holiday Home and rented to Tenants (short term basis)
Building Type
- Free standing Home
- Apartment/Flat/Unit
- Block of Flats/Units/Apartments
- Townhouse
- Semi Detached
- Granny Flat
- Terrace
- Duplex / Triplex / Quadplex
What floor is the property located on
How many units are in the block
Is the property part of a Strata Plan
- Yes
- No
Cover Type
- Building and Contents
- Building Only
- Contents Only
Building
Property address
Construction
Walls
- Aluminium
- Brick Veneer
- Concrete
- Double Brick
- Fibro / Asbestos
- Hardiplank / Hardiflex
- Mud Brick
- Steel
- Sandwich Foam/EPS (Expanded Polystyrene)
- Stone
- Straw
- Vinyl Cladding
- Weatherboard / Wood
- Other
Roof
- Aluminium
- Concrete
- Fibro/Asbestos
- Iron (Corrugated)
- Slate
- Thatch
- Tin/Steel/Colourbond
- Tiles
- Timber
Year Built
Number of levels
Quality
- Standard quality
- Above Average
- Top of the range
Is there a swimming pool, outdoor spa or lift at the property
- Yes
- No
Security
Section to be completed only if Contents cover is selected.
What best describes security on the property's externally accessible doors?
- None
- Deadlocks Only
- Key Card Access Only
- Deadlocks and Key Card Access
What best describes security on the property's externally accessible windows?
- None
- No accessible windows
- Security Bars / Screens Only
- Key Operated Locks Only
- Security Bars / Screens and Key Operated Locks
Alarm Security
- None
- Unmonitored Burglar Alarm
- Monitored Burglar Alarm
Contents
Contents sum insured (excluding Special Contents)
Special Contents
Please list any special contents to be insured
Item # 1
Description
Sum Insured
Type
- Household Goods
- Fixtures and fittings installed if strata unit
- Portable Domestic Appliances
- Swimming pools, saunas and spas not built in, and or their accessories
- Furniture and Furnishings
- Items thinly covered with gold/silver but not jewellery
- Clothing, pedal cycles, surfboards and surf skis over $2,000 in total
Item # 2
Description
Sum Insured
Type
- Household Goods
- Fixtures and fittings installed if strata unit
- Portable Domestic Appliances
- Swimming pools, saunas and spas not built in, and or their accessories
- Furniture and Furnishings
- Items thinly covered with gold/silver but not jewellery
- Clothing, pedal cycles, surfboards and surf skis over $2,000 in total
Item # 3
Sum Insured
Description
Type
- Household Goods
- Fixtures and fittings installed if strata unit
- Portable Domestic Appliances
- Swimming pools, saunas and spas not built in, and or their accessories
- Furniture and Furnishings
- Items thinly covered with gold/silver but not jewellery
- Clothing, pedal cycles, surfboards and surf skis over $2,000 in total
Cover Options
Is your property managed by a professional property agent
- Yes
- No
Do you want cover for Theft by a Tenant
- Yes
- No
Do you want cover for Loss of Rent
- Yes
- No
Loss of Rent Sum Insured
To the maximum of your annual rental income
Do you want cover for Strata Title Mortgagee Protection
- Yes
- No
Strata Title Mortgagee Protection Sum Insured
Do you want cover for Rent Default
- Yes
- No
You must have a Rental Agreement or Periodic Tenancy Agreement in place in order to have cover for Rent Default
Interested Parties
Please list Interested Parties
Name
Other
Number of criminal convictions in the past 3 years
Have there been any claims made at this situation in the last 3 years
- Yes
- No
Year
Claim Type
- Accidental damage at the situation
- Burglary (with break in)
- Bushfire
- Escaped water or other liquid
- Explosion
- Fire (not bushfire)
- Flood – current address
- Flood – Previous address
- Legal Liability
- Loss of rent
- Rent default
- Theft/damage caused by Tenant
- Storm / cyclone or water run-off
- Theft (without break in)
- Other
Year
Claim Type
- Accidental damage at the situation
- Burglary (with break in)
- Bushfire
- Escaped water or other liquid
- Explosion
- Fire (not bushfire)
- Flood – current address
- Flood – Previous address
- Legal Liability
- Loss of rent
- Rent default
- Theft/damage caused by Tenant
- Storm / cyclone or water run-off
- Theft (without break in)
- Other
Year
Claim Type
- Accidental damage at the situation
- Burglary (with break in)
- Bushfire
- Escaped water or other liquid
- Explosion
- Fire (not bushfire)
- Flood – current address
- Flood – Previous address
- Legal Liability
- Loss of rent
- Rent default
- Theft/damage caused by Tenant
- Storm / cyclone or water run-off
- Theft (without break in)
- Other
Other Information
Do you wish to provide any additional information ?
- Yes
- No
Details
- By ticking this box you have advised that you do not wish for your information to be used for the distribution of marketing and advertising material, including additional services, benefits and features which may become available.
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Steel Pacific Insurance Brokers

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1800 072 114

Central Queensland
1800 961 007

North Queensland
1800 629 701

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Ballyglisheen Pty Ltd trading as Steel Pacific Insurance Brokers
ABN 47 075 780 353
AFSL 230634

Name

BHI Landlord Insurance Application

Your Details

Coverage

Building

Security

Contents

Cover Options

Interested Parties

Other

Other Information