To request a quote please fill in the following information as accurately as possible. Please note that we may need to call you before providing a quote if we are unsure of any details.
Date of Birth *
Address to be insured including postcode *
Is the property in a good state of repair? *
No of occupants (above/under 18)
Is the property unoccupied in the day or night?
usually occupied day and nightunoccupied during the dayunoccupied overnight
Are any occupants smokers?
No of bedrooms *
No of bathrooms *
Year property was built
Type of property *
Wall type *
Roof type *
Percentage of roof that is flat
Is the property used for business?
What kind of locks do you have on your windows and external doors?
Does the property have a security alarm?
Does the property have any fire precautions?
Who owns the property? *
Is there an interested party i.e. mortgage holder
Is the property within 400 metres of a river or quarry?
Has the property experienced landslip, subsidence, heave?
Have any special terms or conditions ever been applied to insurance for this property?'
Number of years claim free *
Buildings cover required *
Is accidental damage cover required?*
Detail any claims you have made in the past 5 years
Contents cover required
Total sum of specified items within contents cover *
Unspecified items away from home
Specified items away from home
Number of years claims free
Asprey Harris Insurance Consultants Ltd are authorised and regulated by the Financial Conduct Authority No: 305274
Consumer Credit Act Licence No: 617411
Data Protection Act Registration No: Z5016383
Registered in England No.2670441
Registered Address: Asprey Harris Insurance Consultants Ltd 252a Berkhampstead Road, Chesham, Buckinghamshire, HP5 3ET