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.

    PROPOSER

    Proposer *

    Date of Birth *

    Occupation *

    Email *

    PROPERTY DETAILS

    Address to be insured including postcode *

    Is the property in a good state of repair? *

    YesNo

    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?

    YesNo

    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?

    YesNo

    What kind of locks do you have on your windows and external doors?

    Does the property have a security alarm?

    YesNo

    Does the property have any fire precautions?

    YesNo

    Who owns the property? *

    Is there an interested party i.e. mortgage holder

    YesNo

    Is the property within 400 metres of a river or quarry?

    YesNo

    Has the property experienced landslip, subsidence, heave?

    YesNo

    Have any special terms or conditions ever been applied to insurance for this property?'


    Number of years claim free *

    SUMS INSURED

    Buildings cover required *

    Is accidental damage cover required?*

    YesNo

    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

    Your privacy: We will not store or use your details for any other purpose other than to correspond with you about this enquiry. You can read our privacy policy here