Bikesure: Bikesure Insurance | Bicyle Insurance Australia
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Insurance details
your bicycles
What are the replacement values of your bikes 1?
Please list at least one bike.
Region
NSW
QLD
TAS
ACT
VIC
WA
SA
NZ
Bike Type
Mountain Bike
Road Bike
Time Trial Bike
Track Bike
e-Mountain Bike
e-Road Bike
Year
Make
Model
Construction of frame
Select
Aluminium
Carbon
Titanium
Steel
Value Including Fitted Accessories
Date Of Purchase (MM/YYYY)
Name of Store where Purchased
add another bike
Do you participate in ANY organised bicycle events? Eg. Granfondo, Charity Rides, Triathlon, Racing, Audax
Yes
No
Are you self-employed?
Yes
No
building & contents cover details
Are you renting your property?
Yes
No
What is the replacement value of your Building?
Enter $ 0 if your building is covered under a strata agreement.
What is the replacement value of your Contents including the bikes listed above?
Policy minimum $40,000.
property description
What type of building is the property?
Select
Residential House
Flat or Unit
Townhouse
Whether or not the unit is on the ground floor?
Yes
No
What is the construction of the external walls?
Select
Brick Veneer
Concrete
Double Brick
Timber
Other
What is the construction of the roof?
Select
Tile
Slate
Metal
Cement Sheet
Other
What year was the building constructed?
Connected to Main Water Supply?
Yes
No
Is your Property used for Farming/Hobby Farming?
Yes
No
What type of alarm is installed?
Select
Local
Monitored
Securitel/Landline
No Alarm
KEYED Window Locks?
Yes
No
Dead locks on all external doors?
Yes
No
Security screens on all windows?
Yes
No
Claim History
claim history
Have you had any claims in the past 5 years?
Yes
No
Year of claim
Brief Description
Approximate cost of claim
Add another
Who is your current insurer?
None
Have you ever had any insurance declined, cancelled or refused renewal, had any special condition/ warranty imposed or been required to pay any increased premium or excess on the past 5 years?
Yes
No
Have you ever been charged with, convicted of, entered into a good behaviour bond or do you have any charge pending for criminal offence(s), in the past 5 years?
Yes
No
Have you ever been declared bankrupt in the past 5 years?
Yes
No
Have you ever been aware of any exceptional circumstances which you should disclose in accordance with notice of Duty of Disclosure?
Yes
No
Personal details
personal details
Title
Mr
Mrs
Ms
Miss
Dr
First Name
Last Name
Street Address
Suburb
Postcode
State
Date of Birth dd/mm/yyyy
Preferred Method of Contact
E-Mail
Phone
Telephone
Mobile
(country code is optional)
How did you hear about us?
Select
Friend / Colleague
Stolen Bikes Australia
Robbie McEwen
Katey Gibb
Bicycle Retailer
Sporting Association
Sporting Event
Google Search
Facebook / Social Media
Magazine Ad
Website Ad
Branding / Merchandise
Email
Confirm Email
Promo Code
Message
Home
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Bicycle Retailers
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broker wholesale
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Contact Us
frequent questions
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