Photographers Insurance Application

To receive a quote for Photographer & Videographer Insurance, simply answer all questions outlined in the form below. Our team will be in touch shortly.

All fields marked with an * are mandatory.

Note: You have the option to Save and Complete this form later if needed, simply scroll to the bottom of this email and click the "Save and Complete Later" link.

Insured's Details

Full Insured Name *

Trading As (if applicable)

Contact Name *

Contact Number *

Email Address *

Address of Premises - Principal Business Location *

Street address *

City *

State *

Postcode *

Address Equipment is usually stored *

Street address *

City *

State *

Postcode *

Are you registered for GST? *

YesNo

ABN *

Please provide a business description including the nature of work carried out *

Number of years in business *

Estimated total staff including working directors (Australia only) *

Estimated turnover for current financial year

Australia

USA/Canada

Other

Total

Estimated turnover for next financial year

Australia

USA/Canada

Other

Total

Are contractors employed to do work on your behalf? *

YesNo

Do you always confirm your contractors are covered under Workers' Compensation and liability insurance when working on your behalf? *

YesNo

Are you always noted as principal(s) on Contractor' Workers' Compensation and liability policy(ies)? *

YesNo

Cover Commencement Date *This is an annual policy providing 12 months of cover from the Commencement Date subject to review, acceptance and payment of the annual premium.

Type of Cover Required

Photographic Equipment Insurance Options

Minimum Excess: $200 each claim. An excess of $500 applies for laptop computers, tablets, mobile phones, PDAs and the like as well as claims made outside of Australia.

* Provides extended cover up to 90 days excluding all countries on the "Do Not Travel" and "Reconsider Your Need To Travel" lists as detailed by the Australian Government Department of Foreign Affairs and Travel website .

Note: This foregoing is only a brief summary of the cover and you are advised to read the Policy Document closely for full details. The Policy Document is available for inspection upon request or from our website www.coverforce.com.au. Cover will not attach until the application is accepted and premium paid.

Section 1: Loss of or Damage to your Equipment

Please note:

This section must be completed prior to the commencement of cover and must include all the equipment to be insured. Please specify the type of cover required for each item.
No item will be deemed of greater value than $500 unless specified in the Schedule.
If you are registered for GST the Sum Insured value should be the GST exclusive amount.
Please exclude Sum Insured value for Drones and Time Lapse equipment. Please contact us for a quote.

A schedule of all equipment to be covered is required. Are you ready to provide your equipment schedule now? *

Yes, I would like to provide my equipment schedule nowNo, I will provide the total sum of the insurance I require and provide the full schedule of equipment on acceptance of my quote

Would you like to type your equipment schedule into this form or upload a file? *

Type into this formUpload a file

Your Equipment Schedule can be uploaded as an excel or word document.

For each item of equipment to be insured you must provide the following information:

Brand & Description of Equipment

Serial Number

Sum Insured

Type of Cover
(options are Aus/NZ wide, Worldwide* or Studio Only)

* Worldwide Cover Extension provides extended cover up to 90 days excluding all countries on the "Do Not Travel" and "Reconsider Your Need To Travel" lists as detailed by the Australian Government of Foreign Affairs and Travel website https://www.smartraveller.gov.au/

Please upload your equipment schedule *

Browse

Brand & Description of Equipment *

Serial Number *

Sum Insured *

Type of Cover *

AUS/NZ WideAdd WorldwideStudio

Australia & New Zealand Wide Cover - Sum Insured? *Please enter the total sum of equipment to be insured with Australia & New Zealand Wide Cover. A schedule of items is required prior to cover commencing.

Studio Only Cover - Sum Insured? *Please enter the total sum of equipment to be insured with Studio Only Cover. (Typically items permanently in the studio or home). A schedule of items is required prior to cover commencing.

Total Sum Insured ($) *

Would you like to add Worldwide* Extension Cover?* *

YesNo

* Provides extended cover up to 90 days excluding all countries on the "Do Not Travel" and "Reconsider Your Need To Travel" lists as detailed by the Australian Government of Foreign Affairs and Travel website https://www.smartraveller.gov.au/

What security protects the equipment at the normal place of storage? *Please note, that a minimum of deadlocks (or equivalent security subject to approval by Coverforce) on all external doors is required.

Please specify *

Optional Extensions

Section 2: Public Liability Cover

Essential protection for all photographers, this covers your liability for claims by members of the public who suffer injury or damage to property while on your premises or while you are working at their premises. You can also include cover for liability for goods in your care, custody or control.

Please note: There is an excess of $500 to each property damage claim. This extension cover does not include USA or Canada. Please contact us if USA or Canada cover is required.

Would you like to include Public Liability cover? *

YesNo

Please select an option:

$5,000,000$10,000,000$20,000,000

Section 3: Professional Indemnity Cover

Professional Indemnity Insurance provides protection when you or your employees are sued for an act, error or omission in relation to professional advice given. Our policy covers damages, compensation, interest and costs, and costs of defence.

Please note: There is an excess of $500 to each claim. This extension does not include USA or Canada. Please contact us if USA or Canada cover is required.

Would you like to include Professional Indemnity cover? *

YesNo

Please select an option: *

$1,000,000

General Insurance History

Does the equipment you wish to insure have any existing damage? *

YesNo

Please provide details *

Have you ever had an insurance application, renewal or policy cancelled or declined? *

YesNo

Please provide details *

Have you ever had special conditions or increased premiums imposed? *

YesNo

Please provide details on the special conditions *

Have you ever been charged with a criminal act? *

YesNo

Please provide details *

Have you had other Insurance Claims (Motor Vehicle, Home, etc.) in the last five (5) years? *

YesNo

Please provide details *

Have you suffered loss or damage to any Photographic Equipment in the last five (5) years (insured or not)? *

YesNo

Please provide details *

Are you now, or have been previously insured? *

YesNo

Insurer *

Expiry *

General Insurance History (For Section 3 PI Cover Only)

Have any claims or complaints ever been made against you? *

YesNo

Please provide details *

Has the proposer been involved in any dispute or arbitration concerning professional fees, advice or services during the past ten years? *

YesNo

Please provide details *

Are you currently engaged in (or about to enter into) civil proceedings of either a professional or personal nature? *

YesNo

Please provide details *

Have you ever been subject to disciplinary proceedings for professional misconduct by a professional society or statutory registration board or been called upon to respond to a complaint? *

YesNo

Please provide details *

Do any of the Directors or Employees, AFTER ENQUIRY, have any grounds for suspecting, or are they aware of any circumstances which might give rise to a claim against the proposer or against any of the present or former directors during the past ten years? *

YesNo

Please provide details *

Has any change by way of merger, takeover or change of name occurred in the past 10 years? *

YesNo

Please provide details *

Is the proposer financially associated with any other firm, other than shown on this form? *

YesNo

Please provide details *

Do you have existing Professional Indemnity Insurance cover? *

YesNo

Insurer *

Policy Expiry *

Declaration

Interested parties (e.g. finance companies) *

I have read and understood the Duty of Disclosure and Important Notices *

I acknowledge that if this proposal is accepted that the insurance will be subject to the terms and conditions of the certificate wording and will be subject to my payment of premium. I consent to the use of the personal information about me for the purposes detailed in the privacy statement including disclosure of this information to third parties in connection with this insurance. I declare that the information disclosed in this Application Form is true and correct and that I have not failed to comply with my duty of disclosure nor have I included misleading information or have I suppressed information that may be relevant to the underwriter in considering my proposal for insurance. *

Insured's Signature *

Draw signature|Type signatureClear

Date *

General Advice Warning

This document has been prepared without taking into account your objectives, financial situation or needs. You must therefore assess whether it is appropriate, in the light of your own individual circumstances, to act upon this advice.Please refer to the Insurance Product Disclosure Statement (PDS) prior to making any decision to acquire that product.

Save and Complete Later

Call 1300 503 503 Email photography@coverforce.com.au visit www.photography-insurance.com.au

Coverforce Partners Pty Ltd ABN 57 089 245 465 AFSL 245377