Public Liability Insurance for Mechanics

You have been directed to this page because we need to find out more information about what you do before we can quote. For this reason, we need you to complete this form so that we can get the best quote for you. If you prefer to talk to a broker first, please call 1300 881 779 between 8.15am and 5.15pm E.S.T. business days.
 

If you have spoken to a broker in our office, note their name here so that this quote can be processed by them as they will know something about you already.

Brokers Name:

Client Details

Insured Name

Trading Name

ABN No.(if known)

Full Address

Email Address

Website Address

Phone No. *

Occupation: Mechanic

Please give a full description of mechanical works that you perform.

When did the business start (year)?

 

Cover Required

Please nominate the amount of cover you require:

$5,000,000

$10,000,000

$20,000,000

 

Underwriting Questions

No. of full time employees:  

No. of part time employees:

What is your annual business turnover?
$ 

 

Do you do welding or hot cutting activities away from own premises?
Yes    No

Do you import or export goods/products?
Yes    No

Does the business:
- Perform work at mine sites, either above or below ground?
- Provide products or services intended for use in the mining industry?
Yes    No

Do you provide equipment out on hire?
Yes    No

Do You operate a mechanic's workshop?
Yes    No

Are used automotive fluids and motor oils disposed of in accordance with
relevant regulations?
Yes    No

Is the work site made safe according to relevant statutory obligations,
regulations, public authority requirements and safety requirements?

Yes    No

Do You carry out any work on vehicles used for organised motor racing?
Yes    No

Do you provide services or products for use in the following areas?

  • Aircraft / Airports / Airlines Radar installations
  • Bridge Construction or maintenance
  • Chemical Works, Petrochemical Plants
  • Dams
  • Oil or Gas Production, Pipelines, Offshore platforms
  • Public Utilities (ie Power Plants, Water, Communication)
  • Railways
  • Shipping / Port Authorities
  • Watercraft or Marine Vessels
Yes    No

Contractors

Do you employ contractors or sub-contractors?
Yes    No

If you answered YES
Estimated annual payments to these contractors?
$

Do they have their own Public Liability cover?
Yes   No

Do they have their own Workers Compensation cover?
Yes   No

Labour Hire

Do you use labour from labour hire companies?
Yes    No

 

Your History

Have you or anyone to be insured under this policy:

  • Had insurance cancelled or declined by an Insurer?
  • Had a proposal rejected, renewal refused or claim rejected by an Insurer?
  • Had any special conditions imposed?
  • Suffered a loss whether insured or not (last 5 years only)?
  • Been declared bankrupt or become insolvent?
  • Been charged or convicted for any criminal offence?
Yes    No


Type the above number:



Declaration

By submitting this Declaration, the Applicant acknowledges:

  • they are authorised by each of the other Applicants to make this Declaration,
  • the contents of the Declaration are true and complete,
  • they are under a continuing obligation to immediately inform the insurer of any change in the particulars or statements contained in this Declaration or in the accompanying documents up until the contract is entered into,
  • they authorise the Insurer to give or obtain from other insurers or insurance reference bureaus or credit reporting agencies, any information about this insurance or any other insurance held by the Applicant/s.

Name of person making this declaration: