Please Review Carefully
Before proceeding, ensure you disclose all relevant information. Non‑disclosure may lead to denial or reduction of claims,
cancellation of your policy, or voiding of the contract (in cases of fraud). If anything below triggers a “Yes”, be prepared
to provide details when requested.
- Have you ever had an insurance policy cancelled, declined, or had special terms imposed?
- Have you ever been declared bankrupt?
- Have you ever been involved in a company or business that became insolvent or was subject to insolvency or voluntary administration (e.g. liquidation or receivership)?
- Have you ever been convicted of any criminal offence (other than minor traffic convictions)?
- Have you ever been liable for any civil offence or pecuniary penalty (exceeding $5,000)?