2026 Broadacre Proposal Form

General Details

Type or If

Insured Name *

First Name *

Last Name

Email Address *

Phone Number *

Address *

Town *

State *--- Select State ---NSWVICQLDWASATASACTNT

Postcode *

Property Details

Properties

New Farm Name

Closest Town

State *--- Select State ---NSWVICQLDWASATASACTNT

Latitude

Longitude

Intrested Party

Map

Add Property Remove Property

Coverage Details

Policy Type *

• Final Revision
• After Harvest

Cover Type *

• Hail & Fire
• Fire Only

Decreasing Excess *

• Yes
• No

Existing Damage *

• Yes
• No

Details of Damage

Sharefarming Details

Is your farm sharefarmed? *

• Yes
• No

Sharefarm Details

%Owned

% Insuring

Share Farmer Name

Share Farmer Address

Share Farmer Phone

Add Farmer Remove Farmer

Crop Details

Planting Schedule *

• Complete a field schedule
  Select this option to enter your schedule directly (include any farms and/or crop paddocks not listed)
• Upload a spreadsheet
  Select this option to upload a spreadsheet containing your schedule using our CSV schedule template link listing your property and paddock schedule from last year

Schedule

Farm Name

Paddock Name

Crop TypeSelectWheatBarleyCanolaOatsField PeasBroad BeansFaba BeansLentilsLinseedLupinsRyeTriticaleVetchChickpeasHayFallow(No Crop)Not Insured

Area (ha)

Est Yield (t/ha)

Agreed Value($/t)

Your Share (%)

Add Farmer Remove Farmer

Please retain paddocks from last year and add any additional paddocks for this season. If a paddock has not been planted this year leave crop type blank or enter Fallow (No Crop)

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Note: if creating a new schedule, please use the following column headers, in this order: Farm Name, Paddock Name, Crop Type, Area (ha), Est Yield (t/ha), Agreed Value (t/ha), Your Share (%)

Field Boundary Mapping - KML/KMZ Upload

Field Boundary Mapping - KML/KMZ Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

If you have a mapping file (.kml or .kmz) indicating your farm and paddock boundaries, please select it for upload here. Please note: a 5% discount applies to quotations where a suitable mapping file has been provided. KML/KMZ file of paddock boundaries

Insurance History

Any insurance policy declined or cancelled, renewal refused, special condition applied? *

• Yes
• No

If yes, give details (Year, Name of Insurer(s), Reason):

Have losses occurred in the past 5 years? *

• Yes
• No

Loss Details

Loss Year

Loss TypeSelectHailFireChemical OversprayLivestockTransit

Hectares Lost

Loss Amount

Add Loss Details Remove Loss Details

Declaration

Declaration *

• I have read and understood the Broadacre Policy Wording.

Quotation / Cover

• I would like a quotation emailed to me, or
• I am requesting cover based on the details provided

By submitting this form I/We : have read the Broadacre Policy Wording and understand and agree, subject insurance being issued, to accept the terms, conditions and exclusions of the policy. declare that the answers and statements made in this Proposal are correct and I/We have fully disclosed everything likely to affect acceptance of this Proposal. understand that, if a claim arises under the Policy, all compensation payable will be paid to the Insured Name stated in this Proposal. agree to pay the premium if insurance is issued and that cover cannot be cancelled once it is issued. agree to declare My/Our entire harvest yield from My/Our insured Property within 30 days of harvest completion

Send Crop Proposal Details