Here you will find a range of useful forms, guides and information.  If you can’t find what you are looking for or need further information, call us on 1300 734 359 or email insurance@diversa.com.au.

Personal Statement
Use this personal statement when you are being underwritten for insurance to provide the insurer with details about your health and pastimes.

Diversa Group Life Pool – Change of Details Form

Diversa Group Life Pool Premium Rate Tables
These tables provide the current premium rates applicable to General Membership individuals (including SMSF members) joining the Pool from 1 April 2016. If you would like a cost illustration for your particular situation, please contact your adviser. If you don’t have an adviser, complete a premium quote request and either fax or email it to us. Premium rates for employer groups and superannuation funds are available on request.

Group Life Premium Quote Request
Use this form to obtain a premium quote from the Diversa Group Life Pool. It should be used by individual and SMSF members only. If you are a member of an employer group or other super fund, you should contact your employer or fund administrator for details of the cost of cover for your particular group.

Group Life Premium Quote Request
Use this form to obtain a premium quote from the Diversa Group Life Pool. It should be used by individual and SMSF members only. If you are a member of an employer group or other super fund, you should contact your employer or fund administrator for details of the cost of cover for your particular group.

Customer ID Form – SMSFs
Complete this form to help us verify the identity of your SMSF and it’s trustees when first joining the the Pool.

Customer ID Form – Individuals
Complete this form to help us verify your identity when first joining the the Pool.

Choice of Fund Transfer Form
Use this form to request a transfer of your existing insurance into your super fund via the Diversa Group Life Pool.