Household Goods & Furniture Insurance
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Cargo Safe Insurance - Household Goods & Removal Insurance

Online Quotes 24/7 - Central Ph: (04) 499 7925  New Zealand
This form is exclusively for Household Goods and Personal Effects Insurance where the transit is within New Zealand only. Immediate online quotes are available and you can pay premiums by credit card online. Household Goods and Furniture include (furniture, appliances, electronics, art work, china etc’) as well as Personal Effects.
 
PROPOSER DETAILS -
Section 1
Name of Proposer
     
In which Province of New Zealand will the household goods be shipped from (where does the journey start from)  


Sum of Goods
to be Insured
Removals Distance

click here for Cover Options  We always recommend Cover A because it is much wider cover
COVER A Premium includes Stat' Charges GST & $50 Broker Fee - $200 Claim Excess
COVER B  Premium includes Stat' Charges GST & $50 Broker Fee - $200 Claim Excess
Do you require All Risk cover Option A
Yes
Do you require Restricted Cover Option B   Yes

VOYAGE / CONVEYANCES -
Section 2

How will the Goods be Conveyed Road Air Rail Sea Combined

Address where goods are to be conveyed from
Address where goods are to be conveyed to  
Date of removal & conveyance  
Expected date at destination  

Will the Goods be unloaded & reloaded between the point of departure & final destination Yes No

Name of removal firm handling the conveyance of these goods
PARTICULARS OF HOUSEHOLD GOODS TO BE INSURED-
Section 3

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any

If you already have an Inventory of the Goods to be conveyed please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
If you DO NOT HAVE an Inventory, please select the check box where you can complete an Inventory - You must have an inventory for insurance

Are the Household Goods New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discolouration Yes    No
d. Are there any special packing instructions given to packers, forwarding agents and carriers for the safe carriage of these good Yes    No
Please describe the special instructions given, if any
PROPOSER DETAILS -
Section 4
Name:    
    Name of person, company or entity seeking insurance
   
Suburb:
    Postcode :
   
   

HAVE YOU OR ANY PERSON ASSOCIATED WITH THIS ACTIVITY EVER-
Section 5
a)had a Legal Liability claim made upon you or the other person?  
b)ever made a claim for insurance in respect of the type of cover you require?  
c)been refused insurance?  
d) had an insurance claim of any type refused or reduced?  
e) been charged with a crime of any type?  

Depending on your answers to these five questions we may need to contact you for further information

DISCLOSURE AND ACKNOWLEDGEMENT DETAILS -
Section 6
 
Please examine your Duty of Disclosure
 
Is there anything else you need to disclose to us?
 
If Yes, please write here what it is that you think we ought to know
 
I acknowledge I have read and I agree to the terms and conditions stated Your Answer is Mandatory
 
CREDIT CARD DETAILS -
Section 7

Your credit card will not be processed until insurance cover is confirmed
 
Please complete the authority below
Cardholder Name
Card Number
Expiry Date
Amount $

Monies will not be deducted from your credit / debit card at this stage. A member of our broking staff will contact you by email or phone to confirm that the Underwriter has accepted your insurance proposal. This should happen within hours of your submission. At that point, the premium quoted will be deducted from your credit / debit card and the formal insurance paper work will be forwarded to you
Thank you we will do our best to respond in the next few hours - but we may need to contact you for further information
Household goods furniture & personal effects transit insurance from Cargo Safe,New Zealand’s leading cargo insurance broker for removals.
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