Managing agents
Residential Insurance Services
About us
Insurance quote
Property owners policy
Insurance claims
Risk management
Contents, Car & Travel Insurance
Home
Insurance Quote Request
Name:
Postal address:
Town:
County:
Postcode:
Phone:
Mobile:
Fax:
E-mail address:
Name of policy holder:
Address of building to be insured:
Town:
County:
Postcode:
Type of property:
Purpose built, Timber floors
Purpose built, Concrete floors
Conversion, Timber floors
Conversion, Concrete floors
Number of units:
Number of floors:
Approx. date when built/converted:
month
/
year
e.g 08/1965
yes no
Is the property occupied?
Standard construction i.e. brick with tile/slate roof?
Is more than 10% of the roof flat?
Is the property in a good state of repair?
Is there any evidence of subsidence, ground heave or landslip?
Is the property a listed building?
Is there a managing agent?
If yes, which one?
Statement that best describes residents:
Owner Occupiers / Long Leaseholders
AST / Professional Tenants
Students
DSS / Asylum / Housing Association
Have you been refused insurance or had special terms/ conditions imposed?
Are there any communal facilities ( lift, boiler, swimming pool, gym, etc)?
Are there any commercial units ( e.g. shops or offices)?
If yes please state details?
Have there been any claims made during the last 3 years?
If yes how many?
Please provide details in the comments box
1
2
3
4
5
6
7
8
9
10
Total value of claims paid?. (confirmation will be required)
Any comments etc.:
Renewal date:
/
/
Sum insured: (i.e. declared value)
Current premium:
Current insurer:
Current excess:
Is Employers Liability required?
Is Terrorism cover required?
Is engineering cover required ( lifts/boilers)?
Is Directors and Officers cover required?
You must provide all material information likely to influence the acceptance of this insurance. If you are in any doubt as to whether a fact is material it should be disclosed. Failure to disclose all material facts may invalidate your policy.
