Novated Lease Insurance Application

Looking to use our recommended Insurance Provider for your Car? Complete this Insurance Application to get the process rolling.

Please note that your information is saved on our server as you enter it & may be resumed at a later time if needed.

Need to Talk to Someone First?

Registered Owner

Driver(s) Details

Vehicle Security

Owner/Driver History

Declaration

Step 0 / 3

The Registered Owner of the Car

First Name

Last Name

Phone (Mobile)

Phone (Work)

Street Address

Suburb

Postcode

State

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Registered Owner

Driver(s) Details

Vehicle Security

Owner/Driver History

Declaration

Step 0 / 3

Covered Driver(s)

Please add all drivers - including yourself if applicable.

First Name (Covered Driver)

Last Name (Covered Driver)

Date of Birth

Sex of this Driver

% Use of the Vehicle

What Year Did you Obtain your Licence in Australia

Delete

Add another covered driver (maximum of 5)

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Registered Owner

Driver(s) Details

Vehicle Security

Owner/Driver History

Declaration

Step 0 / 3

Vehicle Security

Does the vehicle have any of the following added aftermarket?

After-market Alarm

Yes

After-market Immobiliser

Yes

After-market Electronic Tracking

Yes

After-market Accessories

Yes

As you indicated Yes to one or more of the above, please provide details of any modifications from the manufacturers standard list for the car:

Is the Vehicle Securely Garaged at Night?

Yes

As you indicated the Vehicle is not Securely Garaged at night, please provide details of where it is parked overnight:

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Registered Owner

Driver(s) Details

Vehicle Details

Owner/Driver History

Declaration

Step 0 / 3

Owner & Driver(s) History

In the last 5 years, have you (or any person likely to drive the car):

Had a claim, accident, or car stolen and/or burnt?

Yes

Claim/Accident(s) | Details Required:

Driver First Name

Driver Last Name

Date of Incident

Insured with

Repair Cost (if known)

Who was at fault?

What happened? Please provide some details:

Delete

Add another claim/accident (maximum of 5)

Had insurance refused, declined or cancelled by an Insurer (or special conditions imposed)

Yes

Insurance Incident | Details Required:

Date of Incident

Insured with

What happened? Please provide some details:

Had a drivers or motorcycle licence cancelled, suspended or endorsed?

Yes

Licence Cancelled/Suspended/Endorsed | Details Required:

Date this Occured

What happened? Please provide some details:

Been convicted or charged with drug use, driving under the influence, or exceeding Prescribed Concentration of Alcohol?

Yes

Substance Conviction | Details Required:

Driver First Name

Driver Last Name

Date this Occured

Please provide some details:

What was the penalty?

Had any driving offences or been issued any speeding or traffic infringements?

Yes

Traffic Infringement(s) | Details Required:

Driver First Name

Driver Last Name

Date of Incident

What happened? Please provide some details:

What was the penalty?

Delete

Add another infringement

Been convicted of fraud, arson, theft or any other criminal act?

Yes

Criminal Conviction | Details Required:

Driver First Name

Driver Last Name

Date of Conviction

Please provide some details:

What was the penalty?

Suffered from any physical or mental disability that may affect your ability to drive (excluding eyesight corrected by lenses)

Yes

Disability | Details Required:

Please provide some details:

In the last 12 months, have you:

Held any car insurance?

Yes

Prior Insurance | Details Required:

Please provide some details:

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Registered Owner

Driver(s) Details

Vehicle Details

Owner/Driver History

Declaration

Step 0 / 5

Declaration

In submitting this form, I,

<first-name>

<last-name>

Acknowledge and understand the Terms & Conditions of the Armada Insurance Plus Motor Fleet Policy V7

Declare that I have received a copy of the Policy Disclosure Statement, Financial Services Guide and have had opportunity to review the Target Market Determination.
I have read the information concerning the duty of disclosure and other important notices; I have answered every question fully & frankly; & I have either completed this proposal form personally, or if it has been completed by someone else, I have checked that the questions have been fully and accurately answered.

Please e-sign your full name below:

‍

Please be advised that the initial approval of this application is based on the information provided, and if additional information is required, you may be contacted by the Fleet Manager.

‍PLEASE NOTE:

This application and any quote given are subject to full assessment on all the information provided by the applicant and are indicative to full assessment by the Insurer. Any failure to provide the correct information may give the Insurer the right to deny any claim.

‍

Your Duty to take Reasonable Care not to Misrepresent:

You have a duty to take reasonable care not to make any misrepresentation when entering into, varying, extending or renewing the Policy.

This means that it is essential that You respond to specific questions that We ask honestly and to the best of your knowledge, including where We ask You to confirm or update information that You have previously given to US when entering into, varying, extending or renewing the Policy.

To assist You with providing Us with honest and accurate responses to any questions We ask of You, We have endeavoured to ensure that any question We ask are clear and easy to understand.

Further, where possible, We have also included examples of the types of responses We are looking for when asking a particular question.

If You are unclear of any particular question or would like us to explain it to you, please get in touch with us and we will explain this to you.In determining whether You have fulfilled this duty to take reasonable care not to make a misrepresentation to Us, We will consider all of the relevant circumstances of a particular case.

If You do not respond honestly and accurately to specific questions that We ask, We may (acting reasonably) cancel Your contract or reduce the amount We will pay You if You make a claim, or both. It is therefore vital that you be honest and specific in Your responses. If Your failure to tell Us is fraudulent, We will refuse to pay a claim and treat the Policy as if it never existed (this does not mean that We will refund any premiums that You have already paid).

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ADDITIONAL INFORMATION

Should there not be enough room to provide your answers to the questions herein, please provide your response in a separate document attaching and forming part of this application for insurance

Privacy Act 1988:

The Fleet manager is committed to protecting your privacy and the confidentially and security of personal information provided by you to us. We are therefore bound by the National Privacy Principles and the Privacy Act 1988 (Cth).

Information we collect:

All the information that we ask for is required for us to effectively coordinate your vehicle insurance and to provide you with the benefits available to you as part of the Fleet Manager service package.

Right of access:

You have the right to access any such information held by the Fleet Manager that relates to you and to collect any information that is inaccurate. If you object to us using the information as described you can advise us at any time in writing.

Permission:

I give express permission to receive Product Disclosure Statements and/or other relevant documentation electronically.

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Thank you, <Name>!

Your Insurance Application has been successfully received.

What happens next?

1-2 business hours

1. We review your insurance request

We will review these details and send them across to the Insurance Underwriter if all looks good

2-6 business hours

2. Outcome of Application

We will hear if the underwriting has been confirmed and accepted, and get back to you on the outcome.

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Please try again and contact us if you're still seeing this issue.

For those Considering a Novated Lease

Know the car? See the Savings.

Considering an EV?
Consider 45% in Savings.

For Businesses Looking for a Novated Leasing Partner

A perk they'll brag about.

For our Current Clients

Manage all of your lease in one place.

Novated Lease Insurance Application

Your Duty to take Reasonable Care not to Misrepresent:

ADDITIONAL INFORMATION

Privacy Act 1988:

Information we collect:

Right of access:

Permission:

For those Considering a Novated Lease

Know the car? See the Savings.

Considering an EV?Consider 45% in Savings.

For Businesses Looking for a Novated Leasing Partner

A perk they'll brag about.

For our Current Clients

Manage all of your lease in one place.

Novated Lease Insurance Application

Your Duty to take Reasonable Care not to Misrepresent:

ADDITIONAL INFORMATION

Privacy Act 1988:

Information we collect:

Right of access:

Permission:

Considering an EV?
Consider 45% in Savings.