Logan Insurance Business Application

Clients typically save $100’s a year on business insurance.

Use the form below to begin the application and we will
contact you for additional details we may need.

Logan Insurance
Business Application

Our clients typically save $100’s a year
on business insurance.
Use the form below to begin the application
and we will contact you for additional
details we may need.

- Step 1 of 8

Your Contact Details

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Your Business

Business Name *

ABN *

Business Occupation *

Your estimated turnover/gross income for next 12 months *

Your estimated payroll for next 12 months *

Total Number of Staff including Directors (Full Time Staff)* *

Total Number of Staff (Part Time / Casual Staff) *

When is your insurance due for renewal?* (if currently uninsured pick today’s date)

Claims History

Have You Made Business Insurance Claims in the Past 5 Years? *

First Claim Date

Amount of Claim

Describe Claim

Action Taken

Do you have Additional Claims?

Duty of Disclosure

Ever had an insurance policy cancelled, declined or terms imposed? *

Specify date and description

Ever been declared bankrupt? *

Specify date and description

Ever been involved in a company or business which became insolvent or subject to any form of insolvency or voluntary administration (e.g. liquidation or receivership)? *

Specify date and description

Been convicted of any criminal offence within the past 5 years (other than minor traffic convictions)? *

Specify date and description

Been liable for any civil offence or pecuniary penalty (exceeding $5,000)? *

Specify date and description

Any other matters you should disclose? *

Specify date and description

Situation Details

Is the Business Address the same as the Contact Address? *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Interested Parties *

Name of Interested Party

Where are the premises located?

Main or Suburban street
Within a shopping centre (With external openings)
Within an Office Block (incl Ground or 1st floor)
Outside Metropolitan, regional or town boundaries
Market
Wholly within a shopping centre (No external openings to outside centre)
Within an Industrial Complex
Within an Office Block (2nd floor or above)
Shipping Container
Other

Floors

Concrete
Brick
Tile
Iron/Steel
Wood
Other

Walls

Concrete/Stone
Brick
Expanded Polystyrene (EPS)
Mixed < 75% Brick/Concrete/Iron on steel
Glass
Iron/Steel/Aluminium
Masonary
Wood
Metal
Other

Roof

Concrete
Tiles/Slate
Fibro
Iron/Steel/Aluminium on wood
Wood
Glass
Other/Mixed
Masonary
Asbestos
Iron/Steel/Aluminium on steel
Expanded Polystyrene (EPS)

Fire Protection (select all that apply)

None
Fire Extiguishers
Hose reels
Sprinklers
Smoke Detectors-Monitored
Smoke Detectors-Non Monitored
Fire Alarm
Monitored Base Alarm
Fire Blankets

Are Flammable Goods stored at premises?

Describe the goods, how they are stored and what protection measures are in place?

Public and Products Liability

Are you insuring for Public and Products Liability? *

Limit of Public and Products Liability

$10 million
$15 million
$20 million
Other

If 'Other' - Please indicate the public and products liability limit you want insured

Do contractors or subcontractors perform work for you? *

What type of work do they do?

Annual payment to subcontractors

Imported Goods - Do you intend to import goods? *

Product - what are you importing?

Approximate turnover generated

Business Property (Fire and other damage)

Are you insuring the Building for Property Damage (Fire and other damage) *

Sum Insured

Are you insuring your Contents for Property Damage (Fire and other damage) *

Sum Insured Content

It is important that the building sum insured represents the full replacement value

Sum Insured Stock

It is important that the contents sum insured represents the full replacement value

Flood Cover?

Glass

Are you insuring Glass? *

This section covers breakage of glass at your business premises and commonly includes external windows and internal glass and partitions.

Business Interruption

Are you insuring for Business Interruption? *

This section can be taken if the Property Damage section is taken, and typically covers your reduction in turnover following a claim.

Gross Profit

Additional Increase in Cost of Working

If known, leave blank if unsure

Claims Preparation Costs

If known, leave blank if unsure

Indemnity Period (If known)

6 months
12 months
18 months
24 months
36 months

Theft

Are you insuring for Theft? *

This section covers theft of items from your premises.

Contents Excluding Stock

Stock in Trade

Cigarettes / Tobacco

Alcohol

Money

Are you insuring money? *

Yes. I want Blanket Cover Amount
Yes. I want Specified Cover Amount
No

This section can cover theft of money from your premises, whilst in transit or from your home.

Blanket Cover Amount

Money in Transit

Money in the building - during business hours

Money in the building - outside business hours

Money in the building - locked safe or strongroom

Blanket Plant and Machinery

Machinery Breakdown

Are you insuring for Machinery Breakdown?

This section can cover breakdown of machinery at your business premises.

Sum Insured

Deterioration of stock

This section can cover food spoilage if refrigeration breaks down

Electronic Equipment

Are you insuring Electronic Equipment breakdown? *

This section typically covers your electronic equipment for breakdown at your business premises.

Sum insured

Do you require Increased Cost of Working *

Covers additional costs incurred during the equipment breakdown

General Property

Are you insuring General Property? *

This section covers your portable business items (tools, electronic items, professional persons’ equipment for loss or damage away from your premises and in your vehicle.

Sum insured

Goods In Transit

Are you insuring Goods In Transit? (within Australia only) *

Do you transport goods and do you want to cover them against loss/damage whilst in transit.

Do you transport temperature controlled goods

Estimated value of annual sendings

Sum insured per shipment

Motor Vehicle(s)

Are you insuring Motor Vehicle(s)? *

Vehicle 1

Make, Model, Year

Registration number

Insurance type

Market Value

Drivers name

Drivers Date of Birth

Garaging Address

Do you have Additional Motor Vehicle(s)?

Have you or any person who will regularly drive the insured vehicle, in the last FIVE Years

Been convicted of, or have pending charges for, including fines or penalties imposed, for driving related alcohol or drug offences?
Had a licence cancelled, suspended or restricted, or been disqualified from holding a licence?
Had any motor vehicle insurance refused?
Had a motoring conviction or prosecution other than parking?
NO to all of the above

Details

Cyber

Do your require Cyber Insurance

Management Liability

Are you insuring for Management Liability? *

Management liability insurance can cover the business and directors against claims brought about them by various parties and can cover the following sections: Statutory Liability, Employment Practices, Crime, Tax Audit.

Limits of Liability

$500,000
$1,000,000
$2,000,000
Other

Workers Compensation

Available for your employees if you are in ACT, TAS, NT, WA – for other states see https://www.safeworkaustralia.gov.au to enquire through your state-based authority

Are you insuring for Workers Compensation *

If Yes - please ensure you have completed the above employee numbers and payroll estimates. Workers' compensation is a compulsory statutory form of insurance for all employers in every state and territory in Australia and provides protection to employees if they suffer a work-related injury or disease

Additional information file upload

Click or drag files to this area to upload. You can upload up to 4 files.

Upload supporting files such as existing policy schedules. *Maximum combined file size 12MB

Our business clients can save
hundreds of dollars annually.

Put us to the test, request a callback.

Savings can occur across all insurance types including Business and Personal, vehicles, travel and more.

Callback Request

Name

Business Name (if applicable)

Phone

Callback

LOGANS NOW OFFER ONLINE APPLICATIONS

To get an insurance quote in the fastest timeframe, online applications are available for our insurances below.
If your insurance needs are not listed please call us on 1300 787 789.

Accident/Disablity/Trauma Insurance
Business/Commercial Insurance
Cyber Security Insurance
Event Insurance
Farm Insurance
Franchise Group Insurance

Home and Contents Insurance
Landlord Insurance
Life Risk Insurance
Marine Transit Insurance
Mobile/Portable Items Insurance
Motor Vehicle Insurance
Personal Insurance

Professional Insurance
Professional Indemnity Insurance
Public Liability Insurance
Strata Insurance
Transit Insurance
Travel Insurance
Other Insurance

Logan Insurance Brokers | ABN 29 001 033 790 | AFSL 233 789

Logan Insurance Business Application

Clients typically save $100’s a year on business insurance.

Use the form below to begin the application and we will contact you for additional details we may need.

Logan Insurance Business Application

Your Contact Details

Your Business

Claims History

Duty of Disclosure

Situation Details

Public and Products Liability

Business Property (Fire and other damage)

Glass

Business Interruption

Theft

Money

Machinery Breakdown

Electronic Equipment

General Property

Goods In Transit

Motor Vehicle(s)

Cyber

Management Liability

Workers Compensation

Our business clients can save hundreds of dollars annually.

Put us to the test, request a callback.

Callback Request

LOGANS NOW OFFER ONLINE APPLICATIONS

To get an insurance quote in the fastest timeframe, online applications are available for our insurances below.If your insurance needs are not listed please call us on 1300 787 789.

Use the form below to begin the application and we will
contact you for additional details we may need.

Logan Insurance
Business Application

Our business clients can save
hundreds of dollars annually.

To get an insurance quote in the fastest timeframe, online applications are available for our insurances below.
If your insurance needs are not listed please call us on 1300 787 789.