Registration Number

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Next, enter your registration.

Registration number

I don't know the registration yet.

You can update this later online or by contacting us.

Finance Provider

Who is your car financed through?

Enter the name of your finance provider

Can't find your finance provider?

Criminal history

In the last seven years, have you or anyone covered by this policy had any criminal convictions in relation to:

Fraud
Theft
Burglary
Arson
Drug cultivation, manufacture, distribution or supply

Select from the following

Insurance History

In the last seven years, have you or anyone to be covered under this policy had any:

Insurance policy declined, avoided or cancelled
Insurance renewal not offered or declined
Special terms imposed
Claim refused or declined

Select from the following

Was it due to:

Fraud
Non-disclosure
Misrepresentation
Non-compliance with any terms or conditions of the policy

Select from the following

Policy holder type

Who will be the policy holder?

Individual

POLICY IN COMPANY NAME

Company details

Name of company

Please enter details of the person who will manage this policy

First name

Last name

Email address

Contact number

POLICY IN TRUST NAME

Trust details

Name of trust

Please enter details of the person who will manage this policy

First name

Last name

Email address

Contact number

{DriverInfo} details

{DriverInfo.Header}

{DriverInfo}
Gender: {DriverInput.Gender} | DOB: {DriverInput.DateOfBirth | formatDate:'yyyy-mm-dd':'dd/mm/yyyy'}

First name

Last name

Add this driver as a policy holder.

Email address

This policy holder would like to receive AA Insurance communications about news, special offers and products and services.

What is a policy holder?

Additional driver info

Update the details for the additional driver

Additional driver
Gender: Not Listed | DOB: 02/03/2005

First name

Last name

Select from the following

Email adddress

This policy holder would like to receive AA Insurance communications about news, special offers and products and services.

What is a policy holder?

Policy holder

Please provide the details of the policy holder

First name

Last name

Date of birth

/

Date of birth

Email address

This policy holder would like to receive AA Insurance communication about news, special offers and products and services.

What is a policy holder?

Policy holders

Add anyone else who shares ownership of this car

These people become policy holders for this policy.

You've reached the maximum number of policy holders that can be applied to this policy

policy holder

Please provide the details of the policy holder

First name

Last name

Date of birth

/

Date of birth

Email adddress

Select from the following

This policy holder would like to receive AA Insurance communications about news, special offers and products and services.

nominate primary policy holder

Please select the primary policy holder

Postal Address

Is the address you've provided also your postal address?

{detailedAddress} {LocationInput.Locality}, {LocationInput.City}, {LocationInput.ZipCode}

You previously told us your car is usually parked here.

Select from the following

Postal address

Start typing your postal address and select from the list.

Please provide your suburb or postcode.

Suburb/Postcode

Street number

Street name

Other details (if applicable)

Unit / PO box no.

Level no.

Building name

Please check that the address is correct before you click next

Please enter a valid address.

Dummy Component required to do hide/show rules on parent container

disclosure and declaration

It’s important you read this Disclosure and Declaration to understand:

Your duty of disclosure – this sets out that the information you give us must be true, complete and correct. If it isn't, your policy may be voided from the start and any claim may not be accepted and/or we may cancel your policy.
How your information will be collected, held and used in line with our Privacy Policy.
AA Insurance’s Financial Strength Rating.

By clicking ‘I understand’, I confirm that I have read and agree to the Disclosure and Declaration.

AAA Extremely Strong	B Weak
AA Very Strong	CCC Very Weak
A Strong	CC Extremely Weak
BBB Good	SD Selective Default
BB Marginal	D Default

Receiving policy documents

How would you like your policy information to be sent?

Select from the following

About choosing policy contact preferences

Which email did you want policy-related communications sent to?

Email

Finally, please confirm the primary policy holder's mobile number

Mobile number

Contact details for policy-related communications

These are used if we can't contact you by post.

Email address

Mobile number

Please send text notifications to this number when documents have been emailed