Insurance Declaration Form Template for New Zealand

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Insurance Declaration Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Insurance Declaration Form

"I need an Insurance Declaration Form for a tech startup in Auckland, New Zealand, that will provide comprehensive coverage for our software development business, including cyber liability and professional indemnity, starting from March 2025."

Document background
The Insurance Declaration Form is a fundamental document in New Zealand's insurance industry, required whenever an individual or organization seeks new insurance coverage or updates existing policies. This form, governed by New Zealand insurance legislation including the Insurance Law Reform Acts and Privacy Act 2020, serves as the primary tool for insurers to gather material information about the risk being insured. It requires the prospective insured to disclose all relevant facts that could influence the insurer's decision to provide coverage or affect premium calculations. The form typically includes sections for personal/business information, risk details, claims history, and specific declarations about the accuracy of provided information. The success of any insurance claim and the validity of the policy itself often depend on the accuracy and completeness of the information provided in this declaration form.
Suggested Sections

1. Personal/Business Information: Collection of basic details about the insured party including full name, contact information, and relevant identification numbers

2. Insurance Type and Coverage: Specification of the type of insurance being applied for and the desired level of coverage

3. Risk Disclosure: Mandatory disclosure of all relevant risks, previous claims, and material facts that could affect the insurance

4. Claims History: Details of any previous insurance claims made in the last specified period

5. Existing Insurance: Declaration of any existing insurance policies that may be relevant

6. Privacy Statement: Statement about how personal information will be collected, used, and protected as per Privacy Act 2020

7. Declaration and Authorization: Final declaration of truth and accuracy, and authorization for information verification

8. Payment Details: Information about premium payment method and frequency

Optional Sections

1. Medical History: Required for health or life insurance applications, including detailed medical conditions and treatments

2. Property Details: Required for property insurance, including building specifications and security measures

3. Vehicle Information: Required for motor vehicle insurance, including vehicle specifications and usage details

4. Additional Insured Parties: Used when multiple parties need to be covered under the same policy

5. Business Operations: Required for commercial insurance, detailing business activities and risk management

6. Overseas Coverage: Required when insurance coverage extends beyond New Zealand

7. Broker Details: Required when the insurance is arranged through an intermediary

Suggested Schedules

1. Schedule A - Asset List: Detailed list of assets to be insured with values and descriptions

2. Schedule B - Claims History Details: Comprehensive breakdown of previous claims including dates, amounts, and outcomes

3. Schedule C - Risk Management Measures: Documentation of existing risk management and security measures

4. Appendix 1 - Supporting Documents Checklist: List of required supporting documents based on insurance type

5. Appendix 2 - Terms and Conditions: Standard terms and conditions applicable to the insurance declaration

6. Appendix 3 - Privacy Policy: Detailed privacy policy explaining how personal information is handled

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant Industries

Financial Services

Insurance

Healthcare

Real Estate

Manufacturing

Retail

Construction

Transportation

Agriculture

Professional Services

Technology

Education

Hospitality

Mining

Energy

Relevant Teams

Legal

Compliance

Risk Management

Underwriting

Claims Processing

Customer Service

Operations

Sales

Account Management

Document Management

Quality Assurance

Finance

Administration

Relevant Roles

Insurance Underwriter

Risk Manager

Compliance Officer

Insurance Broker

Claims Manager

Legal Counsel

Business Development Manager

Account Manager

Policy Administrator

Insurance Agent

Chief Risk Officer

Operations Manager

Financial Controller

Company Secretary

Customer Service Representative

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Workers Compensation Exemption Form

A New Zealand legal document enabling workers and employers to opt out of standard ACC coverage under specific circumstances, with alternative compensation arrangements.

find out more

Insurance Termination Letter

A formal notice compliant with New Zealand law that terminates an insurance policy and outlines the termination terms and conditions.

find out more

Certificate Of Workers Compensation (Insurance)

A New Zealand legal document certifying an employer's workers compensation coverage under ACC and any additional private insurance arrangements.

find out more

Insurance Claim Form

A New Zealand-compliant form for submitting insurance claims, designed to capture all necessary information and evidence for claim processing under NZ insurance law.

find out more

Insurance Waiver Form

A New Zealand-compliant legal document recording the voluntary waiver of specific insurance rights or claims under New Zealand law.

find out more

Accident Claim Form

A New Zealand ACC form for reporting accidents and claiming compensation under the national no-fault accident compensation scheme.

find out more

Medical Claim Form

A New Zealand-compliant form for claiming medical expenses from insurers or ACC, incorporating all necessary elements for healthcare reimbursement processing.

find out more

Insurance Verification Form

A New Zealand-compliant legal document used to verify and confirm insurance coverage details, policy status, and related information.

find out more

Short Term Disability Form

A New Zealand-compliant form for processing short-term disability claims and benefits, ensuring proper documentation and privacy protection under local legislation.

find out more

Dental Claim Form

A New Zealand-compliant form for processing dental treatment claims and reimbursements through insurance providers or ACC.

find out more

Subrogation Letter

A formal document used in New Zealand to transfer an insured's recovery rights to their insurer after claim settlement, enabling the insurer to pursue compensation from responsible third parties.

find out more

Subrogation Form

A New Zealand-compliant legal document that transfers recovery rights from an insured party to their insurer following the payment of an insurance claim.

find out more

Health Insurance Cancellation Letter

A formal letter for cancelling health insurance coverage in New Zealand, compliant with local insurance laws and regulations.

find out more

Life Insurance Cancellation Letter

A formal letter compliant with New Zealand law for terminating a life insurance policy, including policyholder details and cancellation instructions.

find out more

Home Insurance Cancellation Letter

A New Zealand-compliant formal letter template for cancelling home insurance policies, ensuring proper notification and legal requirements are met.

find out more

Non Renewal Insurance Letter

A formal notice under New Zealand law informing a policyholder that their insurance policy will not be renewed upon expiration.

find out more

Workers Comp Waiver Form

A New Zealand-specific workplace document acknowledging ACC coverage terms and establishing injury management protocols within NZ's no-fault compensation system.

find out more

Auto Insurance Cancellation Letter

A formal notice under New Zealand law to terminate an automobile insurance policy, including policy details and cancellation instructions.

find out more

Transfer Of Insurance Form

A New Zealand-compliant legal document used to transfer insurance policy rights and obligations from one policyholder to another.

find out more

Insurance Proposal Form

A New Zealand-compliant form for collecting essential risk information from potential insurance clients to facilitate underwriting decisions.

find out more

Insurance Cancellation Form

A New Zealand-compliant form for formally requesting and processing the cancellation of an insurance policy.

find out more

Insurance Declaration Form

A New Zealand-compliant declaration form capturing essential information for insurance risk assessment and policy issuance.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: https://www.genieai.co/our-research
Oops! Something went wrong while submitting the form.

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our Trust Centre for more details and real-time security updates.