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 Brokers National 

Brokers National Caravan Insurance Cover Includes: Your Caravan, The Annexe, Contents Of The Van, & Liability                                                  Did You Know You Can Either Select Cover Anywhere In Australia Or On Site Only                                     Simply Answer The Questions Below                                 Sometimes The Insurer May Ask For A Photo Of Your Caravan                  

EMAIL Or FAX: 

On-Line Caravan Insurance Quote


 Thank you for considering our on-line caravan insurance quote service. Brokers National has accounts with most insurers and underwriting agencies. We aim to find you the be caravan insurance deal possible.

Please fill in the following form - answering all questions, then either:

1. Click on "Email to Brokers National" at the bottom of this form.  OR                               

2. Highlight this form to "Print It" and then "Fax It" to our office on 03 9791 6633.


 Use the Mouse or the Tab key to move to the next field. We will respond with quotes as soon as they have been received from our insurers.

Caravan Insurance

Caravan, Annexe, & Contents Details:
(Only answer questions relevant to your boat - otherwise leave fields blank)

Caravan - Make:
Caravan - Model:
Caravan - Year of Manufacture:

Caravan - Length:

 metres
Caravan - Number of Berths:
Caravan - Current Estimated Value: $

Annexe - Make:
Annexe - Year of Manufacture:
Annexe made out of:

Canvas                 Vinyl
Aluminium            Solid Walls
Annexe - Current Estimated Value $
Contents - Item Description & Sum Insured:
(List items over $500 that you want covered)		 $
$
$
Do you owe money on this Caravan? Yes No
Is your caravan roadworthy, free of mechanical defects and in an undamaged condition? Yes No    
If "No" provide details:
Does your caravan have modifications or accessories? Yes No    
If "Yes" provide details:

What kind of cover do you want? On Site Only    Transit Australia Wide
Postcode the caravan is usually garaged or stored:


Applicant Details:

Date of birth of applicant (DD/MM/YYYY):   Percentage of use: %
Occupation of applicant:  
How long has the applicant held a licence?   years
Are you entitled to a No Claim Bonus with your current insurer? Yes     No
If yes, please specify what rating:
If you hold rating 1, how many years has it been since your last claim  years

For each other person who will use, tow or carry your caravan:

Date of birth of driver 2 (DD/MM/YYYY):   Percentage of use: %
How long has the driver held a licence?   years
Date of birth of driver 3 (DD/MM/YYYY):   Percentage of use: %
How long has the driver held a licence?   years

Have any of the applicants:
(Note: you must answer these questions)

Been charged with, or convicted of, or penalized for any motoring offences or had a driving licence suspended, cancelled or been endorsed?   Yes No    
Details:
Ever had any insurances refused or cancelled?     Yes No    
Details:
Been charged or convicted of any offence in the last 10 years?   Yes No    
Details:
Been involved in a car or caravan accident, had a car or caravan burnt or stolen, or claimed against an insurance company for damage to a car or caravan, in the past 5 years?   Yes No    
Details:


Any other comments, requests or relevant information you need to add:


Contacting you about your quote:
Please make sure you leave a contact phone number and the best time to call you.
Your Name:
Company Name:
Your Phone Number & Area Code:
Best Time(s) To Call:
Please send my quote by (select at least one): email     phone     fax     mail
Your Email:
Your Facsimile:
Your Postal Address:  

Click On Email Quote To Send Form To Us

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