HOUSE INSURANCE

Your Name

E-mail address (required)

Address

Postcode

Telephone No

Name

Your occupation

Your date of birth

Marital status

Married Single

if married please give your spouse's date of birth

Spouse's occupation

Present Insurer

Date of expiry of present insurance

Have you had any claims or losses in the last 5 years?

Yes No

if yes, please give details including dates

Address of the property to be insured
(if different from that previously supplied)

Postcode

What year was the property built?

Is the property to be insured

please select one >>> Private dwelling house Bungalow Purpose built flats Single private flat Conversion to flats Other conversion  

If the property is a house, is it...

please select one >>> Detached Semi-detached Terraced  

No of bedrooms

No of bathrooms

Constructed of

please select one >>> Brick Stone Concrete  

Roof

please select one >>> Slate Tile Metal Asphalt Concrete  

Is the property

please select one >>> Owned - mortgaged Owned outright - not let Rented from private landlord (furnished) Rented from private landlord (unfurnished) Rented from Local Authority (furnished) Rented from Local Authority (unfurnished)  

Does the property have a garage?

Yes No

if yes is the garage

please select one >>> Detached, built of brick/stone Detached, not brick or stone Attached, built of brick/stone Attached, not brick/stone Integral  

if not brick or stone, what is the garage's construction?

Is the property a listed building?

Yes No

Are there any trees within 7 metres of the property?

Yes No

Does any resident in the property smoke?

Yes No

Is the property situated close to cliffs, quarries, rivers etc?

Yes No

if you have answered 'yes' to the above, how close?

please select one >>> under 250 metres 250 - 500 metres over 500 metres

The property is in a good state of repair

Yes No

Is in a flood free area

Yes No

Has a self contained entrance

Yes No

Is in an area free from subsidence, heave and landslip

Yes No

Has not been underpinned

Yes No

If you have answered 'no' to any of the above please call us free on 0500 401226

Total number of occupants

Are any of these people not members of your family?

Yes No

How many occupants are there under 18 years of age?

Approximately, how many hours per day is the property unoccupied

 hours

Approximately, how many hours per night is the property unoccupied?

 hours

Is the property or any part of it occupied for business purposes

Yes No

if yes, please give details

Buildings cover

What is the rebuilding cost of the property?

Do you require accidental damage cover for the buildings?

Yes No

If you do not require contents insurance click here, otherwise complete the fields below

Contents Cover

How much cover do you require

Please check which of the following you wish to include and give the required sum insured

Description

Required?

Sum insured

Freezer foods

Money

Credit cards

Do you wish to include any specified items on the policy?

Yes No

if yes, please enter descriptions and values

Do you wish to include accidental damage cover on the contents insurance?

Yes No

Does the property have an alarm?

Yes No(if no, please click here)

Type of alarm

please select one >>> 999 line Bell Central Station Alarm (no code) NACOSS Unknown  

Was the alarm professionally installed?

Yes No

By whom?

Does the alarm system have a maintenance contract?

Yes No

Do you have any no claims discount (NCD) realting to the buildings cover?

Yes No

if yes, how much

% or years

Do you have any no claims discount (NCD) realting to the contents cover?

Yes No

if yes, how much

 % or years

Please state your required voluntary excess

please select None £50 £100 £250  

email validation

Due to the amount of SPAM email we recieve please enter the code that you see in the box below to validate this as a genuine quote request... sorry but we have to ask you to do this due to the amount of spam that we receive...