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Change of Address
Please complete this form and your Brokersure representative will be in contact with you shortly
Change of Address
Your Name
ID Number
Email Address
Contact Number
Your New Address
Your New Address
Your New Address
Your New Address
City
City
Province
Province
Postal Code
Postal Code
When will you be moving in?
Is this your:
Main Home
Second Home
Holiday Home
Commune
Do you need us to cover:
Buildings
Contents
Both
You want us to cover the buildings, how much will it cost to rebuild your home from scratch?
Remember to include professional fees, debris removal costs, gates, walls, driveways etc
You want us to cover your contents, do you want us to use the same sum insured as your current home?
Yes
No, I want to change the sum insured to:
New Sum Amount
Is the building financed?
Yes, if so please advise us who the financier is.
No
Financier
Lets talk construction, what are the walls made of?
Brick/Stone/Concrete
Timber/Part Timber
Asbestos
Fibreglass
Other (Please Specify)
Other (Please Specify)
Now onto the Roof, what type of roof do you have?
Tile
Chromadeck/Iron/IBR
Thatch/Partial thatch.
Flat
Other (Please Specify)
Other (Please Specify)
If you have a thatch do you have a SABS Lightning Conductor installed?
Yes
No
What type of home do you have?
Detached House
Simplex/Duplex/Townhouse
Flat
Where is the home situated?
On a farm or small holding?
In a standard residential suburb?
In a Security/Retirement Village?
Is there commercial farming bordering your farm perimeter?
Yes
No
Your new home is in a security/retirement village, what security is there?
24hr Access Control
24hr Security Monitoring
Security Guards
Electric Fence/Boundry Fence around entire Security/Retirement Village
Is your new home:
Next door to vacant land.
Next door to a smallholding.
In an area where new houses are being built.
Within 1km of a taxi rank.
Within 1km of an informal settlement.
None of these are applicable.
You answered YES to the above question, please provide us with more information about where your building is situated.
*
General Questions about the building:
It is in a neighborhood where there are new buildings being built?
It is undergoing renovations?
Part of the building will be used for business purposes?
Is there a Thatch Lapa on your new property?
Is there any additional non-standard construction buildings on the property?
None of the these are appliable.
You answered YES to a Thatch Lapa, what is the approximate distance from the main home?
0-5 meters
6 - 10 meters
11 - 20 meters
Further than 20 meters
You answered YES to the above question, please provide us with more information.
*
Will the home be unoccupied during work hours?
Yes
No
Will the home be unoccupied for more than 60 days a year?
Yes
No
Will the home be hired out, for short or long term rentals?
Yes
No
Are all opening windows fitted with burglar bars?
Yes
No
Are all fixed windows fitted with burglar bars?
Yes
No
What doors are fitted with security gates?
Sliding/Folding doors
External Leading Doors
Interleading door from outbuilding
None
Is your property surrounded by a fence/wall at least 1.8m high?
Yes
No
Is there a fully operational alarm system installed with armed response?
Yes
No
Who provides the armed response
Your Name
In what capacity are you signing?
Please Select Option
As the insured
Spouse/Family Member
Director/Partner/Member of an Entity
Employee of an Entity
Date
Submit
If you are human, leave this field blank.
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Our Business
Insurance
Domestic Insurance
Corporate & Commercial
Hospitality
Marine & Transport
Construction & Engineering
Specialist Liabilities
Medical Aid Gap Cover
Brokersure Assist App
Accreditation
Submit a Claim
Motor Accident Claim
Motor Vehicle Theft
Motor Vehicle Hail Damage
Property Loss Claim
Windscreen Claim
Geyser Claim
Careers
Contact Us
Quote Request
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