If you would like a quote for your Home & Contents policy, please complete the below form.  Once submitted one of our brokers will prepare a quotation and be in contact with you.

 

Privacy

We are committed to protecting your privacy. We use the information you provide to advise about and assist with your insurance and/or financial planning needs. We only provide your information to insurance companies, underwriting agencies, wholesale brokers and premium funders with whom you choose to deal (and their representatives). We do not trade, rent or sell your information. If you don't provide us with full information, we can't properly advise you and you could breach your duty of disclosure. You can check the information we hold about you at any time.

For more information about our Privacy Policy, ask us for a copy or view here. By completing the request below, I certify that I am aware that any collection of personal information is used in accordance with EBM's Privacy Policy.
Insured Name*:
Phone*:
Email*:
Date of Birth*: (of oldest insured)
Policy Commencement Date*:
Cover Level*: ?
Building Type*:
Construction*:
Year Built*:
Unit Number:
Level:?
Street Number*:
Street Name*:
Street Type*:
Suburb*:
State:
Postcode*:
Occupied By*:
Building Sum Insured*: ("NIL" if not required)
Contents Sum Insured:
            Unspecified (general contents)*:
            Specified Contents*:
            Total Contents*:
            If you indicated cover for
            specialised items, please
            detail the items you require
            cover for:
Personal Effects Sum Insured:
            Unspecified*:
            Specified*:
            Total Personal Effects*:
            If you indicated cover for
            specialised items, please
            detail the items you require
            cover for:
Domestic Workers Compensation*:?
Flood*:
Finance Company?*
Is your home on a site exceeding 20,000sq metres?*
Yes
No
Have you or anyone permanently residing with you, been convicted of arson, theft, fraud or violence against any person or property in the last 10 years?*
Yes
No



Have you or anyone permanently residing with you, been convicted of any crime involving drugs, dishonesty in the last 5 years?*
Yes
No



During the last 3 years has any insurer refused to insure your home and/or contents?*
Yes
No


Have you been declared bankrupt and not been discharged for at least 1 year?*
Yes
No

Is the building being let or rented on commercial basis eg. Hotel/Hostel/Motel/Guest House/Boarding House?*
Yes
No



Is the building poorly constructed, badly maintained or subject to a demolition      order?*
Yes
No


Is the building National Trust classified or Heritage Listed?*
Yes
No
Is the building being shared by more than 3 unrelated persons?*
Yes
No
Is any part of the home used for any business, trade or professional purpose, other than home office?*
Yes
No

If Yes, please specify
Is or will the building be unoccupied for any period in excess of 90 consecutive days?*
Yes
No


Deadlocks on all external doors*:
Key Operated Window Locks or Grills on all External Windows*:
Alarm Type*:
If Other, please specify
Claims History:
            No. of Claims in the last 5 years*:

            Details, Claim 1:
                   Date of loss:
                   Type of Claim:
                   Amount:
                   Please advise details of claim:
            Details, Claim 2:
                   Date of loss:
                   Type of Claim:
                   Amount:
                   Please advise details of claim:
            Details, Claim 3:
                   Date of loss:
                   Type of Claim:
                   Amount:
                   Please advise details of claim:
            Details, Claim 4:
                   Date of loss:
                   Type of Claim:
                   Amount:
                   Please advise details of claim:
            Details, Claim 5:
                   Date of loss:
                   Type of Claim:
                   Amount:
                   Please advise details of claim:
Additional Comments
Preferred Method Of Contact*
Phone
Email

Please enter the code you see in the image on the left into the box above. Note: This is case sensitive. e.g 'h' is different to 'H'

 

Key Contacts

Specialists in this area include:

 

gareth greaves

VIC, NSW, SA & TAS

Gareth Greaves

Commercial Division Manager - Melbourne

email Gareth

jonnine gould

Perth & NT

Jonnine Gould

PersonalCover Division Manager

email Jonnine

brooke mclaren

QLD

Brooke McLaren

Commercial Division Manager - Southport

email Brooke

Kushla Harris

 

Kushla Harris

Account Manager

email Kushla

 

Team Member Natalie Wasiun

Kalgoorlie

Natalie Wasiun

Regional Manager - Goldfields

email Natalie

Team Member Natasha Pirrottina

Geraldton

Natasha Pirrottina

Account Manager

email Natasha

Tara Ransted

Karratha

Tara Ransted

Account Manager

email Tara


Quick Contact Form

EBM are able to provide a wide range of services, many of these will require a professional to contact you to discuss precise requirements.

For a general enquiry, complete the below. For a more detailed enquiry please click here.

Privacy Acknowledgement - For more information about our Privacy Policy, ask us for a copy or view here. By completing the request below, I certify that I am aware that any collection of personal information is used in accordance with EBM's Privacy Policy.*
Agreed


Please enter the code you see in the image on the left into the box above. Note: This is case sensitive. e.g 'h' is different to 'H'