Quotation Request

Home Insurance

Your
Details
Your
Home
Your
Home Security
Your
Cover
Your
Claims History
Your
Declaration
Calculations

Your Details

Cover Start Date
Please enter the date from which you wish cover to begin. You cover will run for 12 months, after which cover may be renewed.

IMPORTANT NOTE: You will be unable to specify an inception date in the past or more than 30 days in advance of today's date
Proposer Name(s)
Please include the full names of the proposer to be covered under this policy.
Do you have a Spouse/Partner?
Spouse/Partner
Please include the full name of the Spouse/Partner to be insured.
Are you currently insured for the cover you are requesting?
Is this a property you are looking to purchase and will be occupying within 30 days of purchasing?
Date of Birth:
Proposer.
Date of Birth:
Spouse/Partner
Telephone No:
Daytime
Evening.
Please supply your email address and password?




Occupation:
Employer's Business:
Spouse Occupation
Spouse Employer's Business:
Address of the home to be insured:
Are you:
- Hidden - Used to capture date year moved
- Hidden - Today
-Hidden- Todays Date for Age Calculation
-Hidden- Insured Age
-Hidden- Spouse Age
Do you have a promotional Code?
Please enter your promotional code:
HIDDEN Oldest person

Your Home

Is the address to be insured the same as the correspondence address?
Correspondence Address:
Please enter the address to which correspondence with regards your policy should be sent.
Please provide a reason for having a correspondence address:
Is the home of standard construction?
Standard construction means built of brick, stone or concrete and roofed with slate or tile, except that up to 20% of the total roof area (disregarding garages) may be bitumised felt or similar permanent deck
Please provide additional details on the Home's construction

GENERAL QUESTIONS

1. Have you or any member of your family or any person living with you:
a) been refused insurance or had special terms or conditions applied by an insurer?
Please give an explanation.
2. Is the home
Is the house or bungalow
Is the flat or maisonette
3. When was the home built?
Approximate Year of Construction
4. Number of bedrooms?
(A bedroom is a room used as or originally built to be a bedroom even if now used for other purposes)
5. Is the home listed or is it subject to a preservation order?
What type of listed property is this?
Does any part of the home have a flat roof?
What percentage of the roofing at the home is flat (disregarding garage):
%
6. Is the home:
a) in a good state of repair and will it be so maintained?
Please provide further information.
b) occupied only by you and your family as your permanent residence?
Please provide further information.
c) self contained (i.e. no shared facilities) with its own separate lockable entrance?
Please provide further information.
d) used for any business or professional purpose?
(Limited personal use as an office for clerical use with no business visitors does not need to be disclosed)
Please provide further information.
e) used as as week-end or holiday home?
Please provide further information.
f) regularly left unoccupied (other than for normal working hours and holidays)?
Please provide further information.
g) left unoccupied for longer than 60 days?
Please provide further information.
7. Flood History
a) Has the property, including gardens, ever been flooded?
Please provide further information.
b) Is there any history of any flooding within 500 metres of the property?
Please provide further information.
c) is there any history of problems with inadequate drainage within 500 metres of the property?
Please provide further information.
d) Is the property within 500 metres of the sea, a river, stream or other water course?
Please provide further information.
8. Subsidence History
a) Is the home free of any signs which may be caused by subsidence, settlement or other abnormal movement?
Please provide further information.
b) Has the home been underpinned or provided with other structural support?
Please provide further information.
c) is there any history of subsidence, ground heave or landslip within 100 metres of the property?
Please provide further information.

Your Home Security

1. a) Are all external doors either fitted with a five lever mortise deadlocks which conform to British Standard (BS3621), or the manufacturers multi-point locking system with a minimum of three dead bolts?
b) Do you have an external sliding patio door?
Are they fitted with key-operated security bolts fitted top and bottom in adition to a central locking mechanism, or the manufacturers multi-point locking system with a minimum of three dead bolts?
c) Do you have French windows?
Are they fitted with key operated security devices fitted top and bottom of each leaf in addition to the central lock, or the manufacturers multi-point locking system with a minimum of three dead bolts?
2. Are all ground floor and accessible upper floor windows fitted with key operated window locks?
3. Is a burglar alarm system installed and maintained by a National Security Inspectors (NSI) (NSI now incorporates NACOSS), or a Security Systems and Alarms Inspection Board (SSAIB) approved installer?
4. Are you a member of a Police approved Neighborhood Watch Scheme?
5. Do you have a smoke detector in working order?

Your Cover

Section 1 - Buildings

THE STRUCTURE OF YOUR HOME
Including garages and outbuildings at the insured address
Do you require Buildings Insurance?
1. Building Sum Insured

Please enter the rebuild value of your home including materials and labour. If you are unsure on the rebuild cost of your home, please CLICK HERE to obtain a free quotation from The Building Cost Information Service (BCIS) via the ABI.

£
2. Do you require Accidental Damage Cover?
Are there any Interested Parties to be noted on this policy?
Name of the interested party:
Address:
Mortgage Account Number / Roll Number

Section 2 - Contents

ITEMS KEPT AT YOUR HOME
Including household goods, personal possessions, valuables and home working office equipment
Do you require Contents Insurance?
1. What is the replacement value as new of your contents?
Allow for wear and tear when assessing value of clothing, household linen and pedal cycles.
£
2. Do you require Accidental Damage Cover?
a) Does the total value of jewellery and other valuables* exceed 33.3% of the sum insured?
* Valuables - Jewellery, watches, furs, curios, works of art, gold, silver or other precious or semi-precious metals or stones, or articles composed wholly or in part of any of them; collections or sets of objects whose value lies in the existence of the collection or set rather than in an individual item of it.
b) Do individual items of jewellery and other valuables* exceed £2,000?

(Pairs and sets are regarded as individual items)

Evidence of value not more than 3 years old must be provided for items over £2,000.

Please give details of individual Jewellery items over £2,000:
DescriptionValue
Add row
Do you have any stamp, coin, medal or other collections of valuables exceeding £2,000 in aggregate value?
Please give details:

Section 3 - Personal Possessions

ITEMS THAT YOU TAKE OUT OF THE HOME
Generally known as All Risks Including items of clothing, luggage, sports equipment, pedal cycles, jewellery and watches.

Should you require cover outside your home for jewellery over £2,000 specified above, you will need to specify this again under the specified personal possessions section.
Do You Require Cover For Unspecified Personal Possessions
This means cover outside your home for jewellery, watches, cameras, clothing, glasses/spectacles, furs, baggage, sports equipment, mobile phones, tablets up to £2,000 any one item, pair or set, and pedal cycles up to £750 each.
Unspecified Personal Possessions Sum Insured:
£
Do you require cover for Specified Personal Possessions?
This means cover outside your home for jewellery, watches, cameras, clothing, glasses/spectacles, furs, baggage, sports equipment, mobile phones, tablets over £2,000 any one item, pair or set, and pedal cycles over £750 each. In addition, you can request cover under this section for any other items outside of your home.
Specified Personal Possessions
Description
(including make, model and serial number)		Item TypeValue
Add row

Section 4 - Legal Expenses

COVER UP TO £75,000 FOR LEGAL REPRESENTATION
Including employment disputes, contract disputes, personal injury, clinical negligence, property protection, tax protection, legal defence (as an employee) and identity theft protection.
Do you require cover for legal expenses?
*HIDDEN* Legal Expenses

VOLUNTARY EXCESS

A premium discount is available in return for you agreeing to increase the standard £100 excess (£250 in respect of freeze and escape of water damage) by adding a voluntary excess which will apply to all Sections.
Please tick the appropriate box if you would like to add a voluntary excess.

Your Claims History

Have you experienced any claims or incidents that might give rise to a loss in the past 5 (five) years?
Please provide full claims details...
Date of LossAmountClaim TypeCover Section
Add row
Please indicate the number of years Building no claims discount.
Please indicate the number of years Contents no claims discount.

Your Declaration

Have you had any criminal convictions or cautions (excluding motoring offences) that are not spent under the Rehabilitation of Offenders Act 1974?
Have you ever been declared bankrupt?
Have you ever had any other insurer decline to offer cover or impose special terms?
Important – What you have told us

You must take reasonable care to provide complete and accurate answers to the questions we ask when you take out, make changes to or renew your Policy. If you fail to do so, your Policy may be void, or may be cancelled, or your claim may be rejected or not fully paid. If you are in doubt as to whether you have answered any questions completely and accurately, you should check your records rather than guess.
If you do not select to receive your documentation by email then it will be sent by post and can take a up to 5 working days.

Calculations

Postcode Upper case
Postcode 2 Characters
Postcode 3 Characters
Postcode 4 Characters
Postcode 5 Characters
Building Category
Location Number
Building Sum Insured
£
Year of Claims
Age
Contents Sum Insured:
£
Specified Pedal Cycles
£
Unspecified Items
£
Specified Items
£
Flood Decline?
Subsidence Decline?
Decline for Occupation?
Decline for Employers Business?
Last Year Premium
£
Last Year IPT Rate
%