Strata Unit Underwriters

Quote Request Form for SA

Strata Unit Underwriters offers three packages for Residential Landlord Insurance in SA. This allows you to choose the most appropriate level of cover to meet your needs. The table below shows the amount of cover provided by each of the packages.

Package	Cover for Contents	Cover for Loss of Rent	Cover for Rent Default	Cover for Public Liability
A	$10,000	$10,000	$5,000	$10,000,000
B	$15,000	$15,000	$5,000	$10,000,000
C	$20,000	$20,000	$5,000	$10,000,000

For information on the Residential Landlord Insurance policy please read the Policy Overview and the Product Disclosure Statement and Policy Wording.

To obtain a quote on one of the packages above, please complete the application form below. Our quotation is subject to approval of this application.

Insured Details

Insured Name
Situation of Insured Property
Start Date for Insurance
Mailing Address
Telephone
Facsimile
Mobile
E-mail

Cover Required

Please select the Residential Landlord Insurance Package that you require a quote for

A B C

Duty of Disclosure Details

Have you had any claims in the last 3 years? (If yes, please provide details below)	Yes	No
Has the insurance on this risk ever been declined or had special terms imposed? (If yes, please provide details below)	Yes	No
Are the premises occupied?	Yes	No
Are there any hazards/defects associated with the property? (If yes, please provide details below)	Yes	No