Broker Application

Company Details

Company Name:
Address:
Suburb:
Town / City:
Country:
Post Code:
Website:
Landline Phone No:

Contact Details

Title:
Forenames:
Surname:
Contact phone number:
Alternative contact number:
Position:
Company email address:

Your Comments / Category Requests

If you would like to provide further information or suggest alternative categories please do so in the comments box below:

Comments / Suggestions for new categories of insurance to be added to QuoteRack:

Quote Requests

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Quote Email address:

Free Trial

Before proceeding with your application, please make sure you have read and understood the QuoteRack FREE TRIAL TERMS AND CONDITIONS, as your application may be declined if the required criteria are not met.

You will not be charged for any QuoteRack leads supplied to you during your Free Trial period.

Please note that the granting of a Free Trial is at the discretion of QuoteRack Ltd and may be suspended, restricted or cancelled at any time without notice or explanation.

The number and type of categories of leads available for your selection may be restricted during the Free Trial period.

In all cases, QuoteRack Ltd’s decision is final

Refund Policy

Please make sure you have read and understood the QuoteRack INVALID LEADS REFUND POLICY.

Lead Selection

All currently available categories of lead and the price of each lead are listed below. If you don't see the category of lead that you require please let us know in the comments box provided.

Please select the types of lead that you wish to receive by placing a tick in the appropriate boxes (your selections can be changed at any time, subject to availability).

N.B. Please be aware that categories marked as 'Unavailable' can still be selected but you will be placed on a waiting list.

Business
Cost
  • Blocks of flats insurance
    		•  $12.00
  • Business liability insurance
    		•  $12.00
  • Chip shop / takeaway insurance
    		•  $12.00
  • Commercial property flood insurance
    		•  $8.00
  • Commercial property insurance
    		•  $12.00
  • Cyber liability insurance
    		•  $12.00
  • Door supervisors / security guard insurance
    		•  $12.00
  • Farm Insurance
    		•  $8.00
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $20.00
  • HGV and haulage insurance
    		•  $12.00
  • Hotel and guest house insurance
    		•  $12.00
  • Landlords insurance
    		•  $12.00
  • Licensed trade - bars, clubs and off-licences
    		•  $12.00
  • Manufacturing insurance
    		•  $12.00
  • Marine, freight and cargo insurance
    		•  $12.00
  • Motor trade insurance - with business premises
    		•  $12.00
  • Nightclubs, casinos and adult clubs
    		•  $12.00
  • Office insurance
    		•  $12.00
  • Professional indemnity insurance
    		•  $8.00
  • Pub insurance
    		•  $12.00
  • Restaurant insurance
    		•  $12.00
  • Roofers and scaffolders insurance
    		•  $12.00
  • Salon insurance
    		•  $12.00
  • Security companies
    		•  $12.00
  • Shop insurance
    		•  $12.00
  • Solicitors' insurance
    		•  $12.00
  • Surgery, clinic and practice insurance
    		•  $12.00
  • Tradesmen insurance
    		•  $12.00
  • Vacant business premises insurance
    		•  $12.00
  • Van couriers insurance
    		•  $10.00
  • Working from home insurance
    		•  $8.00
    Car
    Cost
  • 4x4 car insurance
    		•  $8.00
  • Alpina car insurance
    		•  $6.00
  • American car insurance
    		•  $6.00
  • Aston Martin car insurance
    		•  $8.00
  • Audi car insurance
    		•  $8.00
  • Bentley car insurance
    		•  $8.00
  • BMW car insurance
    		•  $8.00
  • Car Insurance – standard risk vehicle / drivers
    		•  $4.00
  • Classic car insurance
    		•  $8.00
  • Custom car insurance
    		•  $6.00
  • Drink-drive car insurance
    		•  $8.00
  • Family fleet insurance
    		•  $8.00
  • Ferrari car insurance
    		•  $8.00
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $20.00
  • High risk occupation driver
    		•  $6.00
  • High value car insurance $100,000+
    		•  $6.00
  • Jaguar car insurance
    		•  $8.00
  • Lamborghini car insurance
    		•  $8.00
  • Land Rover car insurance
    		•  $6.00
  • Left hand drive car insurance
    		•  $8.00
  • Maserati car insurance
    		•  $8.00
  • Mercedes-Benz car insurance
    		•  $8.00
  • Off-road 4x4 vehicle insurance
    		•  $8.00
  • Private hire car insurance
    		•  $8.00
  • Range Rover car insurance
    		•  $8.00
  • Rolls-Royce car insurance
    		•  $8.00
  • Taxi insurance
    		•  $8.00
    Challenge QuoteRack (Priced by category)
    Cost
  • Challenge QuoteRack
    		•  $0.00
    Home
    Cost
  • Blocks of flats insurance
    		•  $12.00
  • Flat insurance
    		•  $6.00
  • High value home insurance (high net worth)
    		•  $8.00
  • Homeowners buildings and/or contents insurance
    		• $6.00
  • Hotel and guest house insurance
    		•  $12.00
  • Landlords property and legal insurance
    		• $12.00
  • Self-build property insurance
    		•  $4.00
  • TV/film/radio celebrity property insurance
    		•  $6.00
  • Unoccupied home insurance
    		•  $8.00
  • Vacant business premises insurance
    		•  $12.00
  • Working from home insurance
    		•  $8.00
    Leisure
    Cost
  • Boat insurance - cruisers, narrowboats and barges
    		•  $6.00
  • Jet-ski insurance
    		•  $4.00
  • Motorhome and campervan insurance
    		•  $7.50
  • Yacht insurance
    		•  $6.00
    Life
    Cost
  • Company director life insurance
    		•  $12.00
  • Critical illness protection
    		• $12.00
  • Existing medical condition life insurance
    		•  $12.00
  • Hazardous pastimes life insurance
    		•  $12.00
  • High risk occupation life insurance
    		•  $12.00
  • High value life insurance cover
    		•  $12.00
  • Income protection insurance
    		•  $12.00
  • Life insurance - standard
    		•  $12.00
  • Previously rejected for life insurance
    		•  $12.00
  • Shareholder protection
    		•  $12.00
    Bike
    Cost
  • Chopper insurance
    		•  $6.00
  • Classic motorbike insurance
    		•  $6.00
  • Motorbike insurance
    		•  $6.00
  • Quadbike Insurance
    		•  $6.00
  • Trike insurance
    		•  $6.00
    Travel
    Cost
  • Annual travel insurance (multiple trips)
    		•  $6.00
  • Hazardous or extreme sports travel insurance
    		•  $2.00
  • Travel insurance - single trip
    		•  $4.00
  • Winter sports travel insurance
    		•  $6.00
    Van
    Cost
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $20.00
  • HGV and haulage insurance
    		•  $12.00
  • HGV fleet insurance
    		•  $20.00
  • Mobile catering vans
    		•  $8.00
  • Modified van insurance
    		•  $8.00
  • Non-standard or high-risk occupation van insurance
    		•  $6.00
  • Refrigerated van insurance
    		•  $8.00
  • Removal van insurance
    		•  $6.00
  • Scrap metal dealers van/truck insurance
    		•  $10.00
  • Skip lorry insurance
    		•  $8.00
  • Tipper van insurance
    		•  $8.00
  • Truck insurance (more than 7.5 tonne GVW)
    		•  $6.00
  • Van insurance (less than 7.5 tonne GVW)
    		•  $6.00
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