Taxi Insure - Comprehensive Insurance Enquiry
1. Insured First / Last name
2. Address
3. Email address
4. Phone number
5. Start/Renewal Date
MM
/
DD
/
YYYY
6. Location of Use
7. Main Driver Name
8. Main Driver Date of Birth
MM
/
DD
/
YYYY
9. Vehicle Year
10. Make
11. Model
12. VIN
13. Registration/Plate Number
14. Odometer Reading
15. Taxi Network/Service Provider the Taxi belongs to
Please select
Central Coast Taxis
GM Cabs
Illawarra Taxi Network
Legion Cabs
Manly Cabs
Premier / Silvertop Cabs
RSL Cabs
St George Cabs
13 Cabs
None of the Above
Please select
16. If the Taxi Company/Service Provider you are with is not in the list above, please provide the name of the Taxi Company/Service Provider the Taxi belongs to below
17. Industry Equipment Value
Please select
$3000
$4000
$5000
$6000
$7000
$8000
$9000
$10,000
Please select
18. Does the Taxi have Wheelchair Access?
Yes
No
19. If Yes for Wheelchair Access, is the access Aftermarket or Flashcab?
Aftermarket
Flashcab
20. Value of Hoist
Please select
$10,000
$15,000
$20,000
$22,500
$25,000
Please select
21. Is Vehicle fitted with a Dashcam?
Yes
No
22. Would you like Downtime Cover?
Yes
No
23. Are you a Taxi Owner Driver?
Yes
No
24.
How many full years have you held current and continuous commercial motor insurance for the proposed vehicles?
25. Number of Years Owning/Operating Taxi Business
1
2
3
4+
26. Have there been any claims made in the past 5 years for a similar type of policy?
Yes
No
For all new business quotes and renewals a “Claims History Report on the current insurers letterhead for at least the last 5 years” is required to be provided by the party who is seeking this insurance cover.
Note
- this will not apply to new operators that are starting out as a new entity rating will be applied.
27. Have you or any of your drivers had a license suspended for any reason including DUI offenses in the last 5 years?
Yes
No
28. Have any of the vehicles to be insured been modified from manufacturer specification to enhance performance?
Yes
No
29. Are all the vehicles in a safe, roadworthy, and undamaged condition?
Yes
No
30. Have you ever been convicted of a criminal offence in the past 10 years (5 years if juvenile)? or if outside of these years any convictions that have had a prison sentence greater than 30 months?
Yes
No
31. Have you, or any business you were associated with, ever been declared bankrupt, had a receive appointed, been liquidated, or, had a default judgement entered against you?
Yes
No
32. Have you ever had an insurance policy, or a claim refused or declined in the last 5 years?
Yes
No
33. Which Insurance Company is your Current Insurance with?
34. Do you have more than a vehicle you would like to get insured? Please let us know and we will reach out to you for further information
Yes
No
Verification
SUBMIT FORM
Please wait...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20