Motor Vehicle

When you need broad cover at competitive prices, just ask your EBM account manager for advice. Our motor vehicle insurance team will research the most suitable policies for your vehicle type and driving requirements (eg, work or family or both, long distance or city driving, vehicle age etc), and make sure you get exactly the cover you need. If you need to make a claim, our friendly staff will do everything possible to get you back on the road quickly.

 

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

 

If you would like a quote for your Commercial Motor Fleet, please contact us via the Quick Contact Form on the right and a broker will 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.
Contact Person*:
Contact Phone*:
Contact Email*:
Contact Postal Address*:
Name of Registered Owner*:
Driver Details:
Registered Driver*:
Date of Birth*:
% of Use*:
Years Driving*:
At fault claims last 3 years*:
Gender*:
Other Regular Driver:
Date of Birth:
% of Use:
Years Driving*:
At fault claims last 3 years*:
Gender*:
Vehicle Details:
Year*:
Registration No.*:
Make & Model*: (eg: Kia Pregio)
Body Type*: (eg: Sedan or Ute)
Colour*:
Modifications*:
Series:
Transmission*:
Use of Vehicle*:
Business Description: (eg: courier, carpenter)
Security*: (eg: Alarm, Immobiliser)

Was the car purchased as new                        

in the last 12 months?*:

 

If Yes; Year, Value & Purchased from:                 

 

If No, What year was the vehicle purchased?   

 

Suburb where parked at night*:
Type of parking*:
Type of Cover:
Basis of Settlement:?
Sum Insured:
No Claim Bonus %:
Accessories
Cover Required:
Finance:
Interested Party*:
Finance Type*:
Optional Benefits:
NCB Protection*: (one at fault claim per year without reduction in NCB)
 
Hire car following an accident*:
Windscreen Protection*: (one windscreen/window claim per year without the application of excess or loss of NCB)


 
Tools of Trade*:
Voluntary Excess:
Is a voluntary excess for reduction in premium to be included in the quote:
 
If yes, how much?
Loss History - has the registered owner/insured &/or any driver to be nominated in the policy:
 
1. Has any insurer refused or cancelled cover on any of your policies or required special terms to insure you in the past 12 months?*
2) Have you, or any person who will drive your car(s), in the past 12 months
a) Been charged with, or convicted of, or penalised for, any motoring offences? (This includes on the spot fines but does not include parking offences)*
b) Had a driving licence suspended, cancelled or restricted by endorsement?*
c) Been charged or convicted of any criminal offence?*
3) Has your car been modified or converted from the Maker's specifications or fitted with accessories other than those supplied as Maker's options?*
4) Are there any other material facts that you need to tell us? (refer to your policy booklet)*
If yes to any questions, please give details (including dates and amounts paid or penalty received)
Additional Comments
Preferred Method Of Contact*
Captcha Code

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

Team Member Kushla Harris

Bunbury

Kushla Harris

Assistant 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


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