About You
Your Car
How You Drive
Where it lives
The driver
Other drivers
Ownership
Final Checks
Summary
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What is your name?
*
Which of these is you
*
Phone number
Email
Address
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Do you know your rego?
*
Yes
No
Vehicle
Year
Make
Model
Variant
Engine
Cylinders
Style
Est. Value
Segment
N V I C
Does the car have any of the following modifications that were not part of the original sale of the vehicle when new? (Body kits or body kit components, Engine performance enhancements, Non standard wheel sizes, Custom paintwork, Lowered suspension, Altered exhaust system)
Yes
No
Does the vehicle have any unrepaired accident or hail damage?
Yes
No
Is the vehicle currently insured?
Is there any finance on the vehicle?
Fully Owned
Secured Loan
Unsecured Loan
Lease
Novated Lease
Rent To Buy
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How many hours per week do you plan to use the vehicle for Ridesharing activities?
*
Do you also use the vehicle to deliver food or packages?
Yes
No
Is the vehicle used for any of the following purposes? (As a taxi available for unbooked services (not including Rideshare activities), As a rental vehicle available for periods less than 3 months, As a courtesy car, Available under car sharing schemes, Paid Driving instruction, Emergency services, Security patrols)
Yes
No
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Where is the vehicle normally kept when it is not in use?
*
Do you declare that your business is exempt from NSW Stamp Duty?
Yes
No
Where is the car parked when it's at this address?
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Who Will Be Driving The Vehicle For Ridesharing Activities?
*
First Name
*
Last Name
D O B
Gender
Does the Rideshare driver have an Australian Drivers licence?
Has the Rideshare Driver incurred any driving licence demerit points in the last 3 years?
How many full years of comprehensive car insurance has the Rideshare Driver had over the last 5 years? (The insurance must have been in your name either on this or any other vehicle)
Has the Rideshare Driver had any motor insurance claims in the last 5 years, regardless of who was at fault?
Yes
No
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Are there additional drivers you wish to add to your policy to be covered for personal use?
*
Yes
No
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Who is the registered owner of the vehicle?
*
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In the last 5 years, has an insurance company cancelled or refused to renew insurance for any of the listed drivers?
*
Yes
No
In the last 5 years, have any of the listed drivers had a licence suspension or cancellation, or had a licence restrcition imposed? (not including when due to unpaid parking tickets)
Yes
No
In the last 10 years, have any of the listed drivers been convicted of a criminal offence including drug and aclohol-related driving offences (DUI)?
Yes
No
In the last 5 years have any of the listed drivers declared bankruptcy or had a default judgement for outstanding debts?
Yes
No
Excess
Windscreen Cover
Yes
No
Hire car cover
Yes
No
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Who is covered
Policyholder name
Named RideShare driver
Confirm your policy details
Vehicle owner
Insured for RideShare
Email address
Address
Mobile number
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ANNUAL PREMIUM
$0.00
Typically around 10% lower than comparable market pricing.
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