Quote Request

Complete the form below to request an Accomsure Quotation.

Duty of Disclosure

Under the Insurance Contracts Act, you have to disclose every matter that you know, or could reasonably be expected to know, is relevant to the Insurers decision whether to accept the risk of insurance and on what terms. The duty of disclosure applies on each and every occasion you seek new insurance cover or renewal, alter or extend existing cover.

Your duty does not require discloser on any matter

  • that diminishes the risk to be undertaken
  • that is common knowledge
  • that the Insurance Company knows or in the ordinary course of its business ought to know
  • as to which the Insurer waives compliance with your duty

It is essential that you comply with your duty of disclosure as the Insurance Company may be entitled to deny a claim, reduce it’s liability under the contract of insurance or cancel the contract from its beginning.


    Please answer the following questions (check Yes or No)

    Has any Insurer with respect to any insurance policy held by you or any other person included as an Insured:

    a) refused to renew, cancelled, or terminated a policy of insurance? YESNO
    b) imposed special or restrictive conditions, increased excess or premium? YESNO

    Have You or any other person included as an Insured:

    c) made any claims in the last 5 years on any insurance policy?asd YESNO
    d) had a claim refused or rejected by an Insurer on any insurance policy? YESNO
    e) been convicted of a criminal offence? YESNO
    f) been placed into administration, receivership, liquidation, bankruptcy? YESNO

    has any person who will who will drive your vehicle(s) had any convictions for driving under the influence of alcohol or drugs, or had a licence cancelled or suspended in the last 5 years?

    h) have anything else to declare under your duty of disclosure? YESNO

    Your Details

    Insured Name:
    Trading Name:
    Period of Insurance: From:
    Current Insurer:
    Current Broker:

    Your Business

    Please select: Hotel - BoutiqueMotelServiced ApartmentsHoliday CabinsBed & BreakfastGuesthouse

    Please contact our office for information about Backpackers, Caravan Park, Hotel / Pub / Tavern, Resort, Health Retreat, B&B Self Catering or Farm Stay.


    Is the Business a AAA Tourism member   YESNO
    If yes, what is the membership number  

    How many accommodation rooms?

    Does your manager have > 2 years experience in this business   YESNO
    Does the owner/manager/staff live on site 24 hours a day   YESNO
    Annual Turnover $
    Non-Accommodation Turnover $
    Is there a licence to sell alcohol   YESNO
    Is there a restaurant other than for breakfasts only   YESNO
    Restaurant Seating capacity  
    Is there a function or conference centre   YESNO

    Is there a swimming pool or outdoor spa?


     If yes is it fenced to Australian Standards with signs posted specifying usage, accepted behaviour and life saving procedures


    Do all other public/guest faclilities conform with all local, regulatory and/or Australian Standards?



    Year of Construction
    How many floors does the building have?
    Is the premises on town water YESNO


    Walls Brick or ConcreteIronTimber or FibroOther Other:
    Floors ConcreteTimberOther Other:
    Roof MetalTileConcreteOther Other:

    Fire Protection

    Hose Reels/Hydrants YESNO

    Smoke detectors hardwired and monitored

    Fully Sprinklered to Australian Standards & Serviced YESNO


    Excluding guest rooms – external doors fitted with double keyed Deadlocks YESNO

    Insurance Cover

    Property Excess:   $500$1000
      Building $
      Contents including stock $
      Removal of Debris $
    Business Excess:   Same as property
      Gross Income $
      Additional Increased Cost of Working $
      Claims Preparation Costs $
      Indemnity period   6 Months12 Months18 Months24 Months
    Theft Excess:   Same as property
      Contents and Stock excluding Tobacco Products $
    Money Excess:   $500$1000$2000
      Blanket cover subject to Limits for 3) & 5) below $

    Covering Money Under items 1-5 below with Money on Business Premises during Business hours and in Private Residence limited to a maximum of $ 7,500 or the sum insured whichever is the lesser

    1. Money in Transit
    2. Money on Business Premises
    3. Money on Business Premises outside Business hours
    4. Money on Business Premises in a locked Safe or Strongroom
    5. Money in a Private Residence
      Limit any one item   $10 000$20 000
    Machinery Breakdown Excess:   $500$1000$2000
      Limit any one item   $10 000$20 000
      If cover is required for an item in Excess of $ 20,000 please provide details  
    Stock Deterioration of Stock $
    Electronic Equipment Excess:   Same as property
      Limit any one Loss $
      Electronic Data and Electronic Data Media $
      Increased Cost of Working $
    Broadform Liability Excess:   Same as property
      Limit of Liability   $10 000 000$20 000 000
    Glass Excess:   Same as property
      Replacement Value   YESNO
    General Property Items Excess:   Same as property
    Employee Dishonesty Excess:   Same as property
      Sum Insured   $10 000$20 000Not Required
    Tax Audit Excess:   Same as property
      Sum Insured   $10 000$20 000Not Required
    Transit Excess:   Same as property
      Sum Insured   $10 000$20 000Not Required
    Employment Practices Excess:   $2 500$5 000
      Sum Insured   $100 000$250 000Not Required
    Statutory Practices Excess:   Nil$2 500
      Sum Insured   $250 000Not required

    Commercial Cooking Condition

    If there are commercial cooking facilities at the premises can you confirm that:

    1. That the exhaust / extraction system ducting is professionally cleaned annually
    2. That the exhaust / extraction system filters are cleaned weekly
    3. That a minimum of 2 x 4.5kg dry chemical extinguishers are located within the kitchen at a suitable location which generally complies with the following requirements:
      • the extinguishers shall be in a conspicuous and readily accessible position
      • where practicable, the extinguishers shall be located along normal paths of travel and near exits they shall not be located in areas where they will be exposed to temperatures outside of the range 50C to -50C
    4. That a fire blanket is located in the kitchen.
    5. Charcoals are removed from the premises and extinguished, or a stainless steel lid placed over the top of the charcoal bed during non trading hours.
    I confirm that I am compliant with the above: YESNO

    Steadfast - Strength when you need it / Westcourt General Authorised Representative / Westcourt General Authorised Representative. Accomsure is a registered trademark of HHIA Pty Ltd T/as Accomsure ABN 49 138 740 468