Is your home fully protected ? Let us help you look after your home and its contents.
Quality controlled by MBGJ.ORG and Islandinsurance.co.uk
 

PERSONAL DETAILS

Title  
Forenames

The information is only used for insurance quotation.

Alternatively we happy to call you when it's convenient for you.

Urgent?
give us a call

0870 787 0260

 

Surname
Postcode
  
Date of Birth
Marital Status
Occupation & Industry
Resident in the UK since
First Time Buyer?
Your Status
Quote required for renewal date or first possession

BUILDING DETAILS

Year Property Built? or length of tenancy
Property Type?
Walls Brick / Stone ? if other
Roof Slate / Tiles ? if other
No of Bedrooms?
Rebuild Value Insured:
Excess ? (Amount you pay)
Including Accidental Damage?
Free from subsidence?
Free from flooding?
Is your home a listed building?
Is your home ever left for more than 30 days ?
Is your home occupied during the day ?

CLAIMS IN THE LAST 5 YEARS
Date: no entry if none
Amount:

CONTENT DETAILS

No content jump section 
Content Sum Insured
Excess ? (Amount you pay)
Accidental cover for content
Locking windows
External Locks:
Burglar Alarm
Make/Type
Neighbourhood Watch
Smoke Detectors
Single items more than 1000 £ The first offer will exclude these. For security reasons this should only be discussed over the phone.

CLAIMS IN THE LAST 5 YEARS

Date: no entry if none
Amount:

ADDITIONAL RISKS
Possessions Away from Home: ?
Unspecified Sum:
Specified Sum:
Money/Credit Cards?
Frozen Food?
Cycles? Total value
No. of Cycles?
Previous / Present Insurer:
How Long Previously Insured?
Previous Policy Excess?
Direct Debit Required?

CONTACT INFORMATION
If you have already been given a quote please state amount:
Please select how you would like to receive your quotation:
By E-mail
By Telephone
Time
Telephone
 If not indicated we will not contact you by phone but a number is required.
E-mail address
Important as this is the main contact form we use.
 
 
 

 

 

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