Home insurance enquiry from Ross Gower

Enter Policy holder details

What is your email address?

What will this be used for?

Your email address will be used to contact you with regards to your policy, as well as for sending your policy documents and for retrieving your quote.

What is your date of birth?

Title

First name

Last name

Middle names

What do I put here?

Please enter any middle names you have.

Does the policy need to be in the name of a company?

Yes No

Company Policy

Is this policy for a individual or for a company.

Company

Please enter the name of the company the policy is to be in the name of.

Postcode

Street 1

Your contact address information

Please ensure that this is a valid Channel Island or Isle of Man address.

Street 2

Your contact address information

Please ensure that this is a valid Channel Island or Isle of Man address.

Town

Your contact address information

Please ensure that this is a valid Channel Island or Isle of Man address.

County

Your contact address information

Please ensure that this is a valid Channel Island or Isle of Man address.

Mobile

Telephone

Please remember to include your island dialling code

Relationship status

Employment status

Occupation

Type of business

Is the policy to be held in joint names?

Yes No

If you are planning on taking out this policy in a joint name, then please select yes and provide their details

What is your date of birth?

Title

First name

Last name

Middle names

What do I put here?

Please enter any middle names you have.

Occupation

Let us know about your Home

How many bedrooms does your property have

Please note

a bedroom is defined as any room originally designed or converted for sleeping in, even if they are not used as a bedroom any longer.

How many bathrooms does your property have

What type of house are you insuring?

What floor is the flat located on?

Is the flat purpose built?

Yes No

Is the property Listed?

Yes No

What is it's listing grade?

What year was the property built?

Is any part of the home used for business/working from home?

Yes No

Is your home...

self contained with a separate lockable entrance under your sole/family control?

Yes No

your main residence, occupied by you and your family, and fully furnished?

Yes No

ever unoccupied for over 30 consecutive days?

Yes No

Buildings Condition

Has the property ever been underpinned, or had structural support or been monitored for subsidence, landslip or heave?

Yes No

For how many days?

Has your home or any building nearby been damaged by subsidence, heave, settlement or landslip, or show signs of cracking or bulging of walls?

Yes No

Are the buildings being monitored for subsidence, heave or landslip. Have they ever been monitored for subsidence, heave or landslip, or suffered any subsidence, heave or landslip?

Yes No

Has any survey carried out on your home ever reported settlement or movement of buildings? (If yes, please enclose a copy with this proposal form)

Yes No

Are you aware that any neighbouring buildings have been the subject of an occurrence of subsidence, heave or landslip?

Yes No

Have the buildings of your home been extended within the last 25 years?

Yes No

What works where carried out?

Are there any trees or shrubs within 7 metres (22 ft) of your home (whether inside or outside your garden) which are more than 3 metres (10 ft) tall?

Yes No

Is the home in a good state of repair?

Yes No

Has the property ever flooded or any neighbouring properties flooded.

Yes No

What percentage area of the roof is flat?

What is the flat roof constructed from?

What is the Property constructed from e.g. block, brick, timber, stone etc?

Property Construction

What is the roof constructed from?

Are any works ongoing or planned at the property in the next 12 months?

Yes No

Works Details

Is the property situated within 400m of the sea, or any other body of water?

Yes No

This includes: Douits, streams, reservoirs, rivers or lakes

Residents

How many people occupy the property?

How many are under 18 years old?

How long have you lived in the property?

Is any part of the property let to tenants/lodgers?

Yes No

Security Details

External door locks

Please choose from the list for the type of locks used on your external doors

A simple guide to door locks

Do you have any Patio/sliding doors?

Yes No

What type of locks do your patio/sliding doors have?

Please choose from the list for the type of locks used on your external doors

A simple guide to door locks

Do you have any French/double doors?

Yes No

What type of locks do your French/double doors have?

Please choose from the list for the type of locks used on your external doors

A simple guide to door locks

Do all windows have key operated locks?

Yes No

If all your windows don't have key operated locks, please provide details

Do you have any skylight windows?

Yes No

What type of locks do your skylight windows have?

Please choose from the list for the type of locks used on your external doors

A simple guide to door locks

Is there an intruder alarm fitted?

Yes No

Is the property fitted with smoke alarms?

Yes No

Is there a safe in the property?

Yes No

Buildings cover

Buildings Amount insured

Full cost of reconstruction in their present form

Unsure of your buildings value? Use our calculator!

This amount must include all outbuildings, garages, domestic oil & gas pipes, domestic fuel oil tanks, swimming pools, tennis courts, drives, patios, terraces, walls, gates and fences.

Let us know about your belongings

Contents Amount insured

General Contents within the home - Full cost of replacement as new

Unsure of your contents value? Use our calculator!

Please list any individual items, valuables or collections worth over £1,000 kept within the home.

Add Specified possessions

Please list any individual items or valuables that you may take out of the home.

Add Personal possessions

For example: laptops, jewellery, bicycles.

Claim Details

Have you made any claims in the last 10 years?

Yes No

What claims must I declare?

You must notify us of any claims you have made or have been made against you.

Do you have any Claims

Add Claim

Have you the insured or any person residing with you:

Been declared bankrupt or insolvent or been subject to bankruptcy proceedings or insolvency proceedings in the UK, Channel Islands or Isle of Man?

Yes No

Been refused insurance or had special terms or conditions applied or cover cancelled for any of the events you now wish to insure?

Yes No

Been convicted of, or have any prosecution pending for any criminal offence? (other than a driving offence)

Yes No

What cover do you require?

Do you own the home?

Yes No

If you have a mortgage answer YES

Please give the name and address of any holder of a financial interest in your home

e.g. Bank or Building Society here

Are you a first-time buyer?

Yes No

Do any residents smoke in the property?

Yes No

How long have you held home insurance? (years)

Please round your answer down to the nearest whole year e.g. if you have held home insurance for 1 year 11 months, the answer would be 1 year.

What is the expiring premium?

Who is the current insurer?

When would you like your cover to start?

Today

Tomorrow

Home Insurance Enquiry

Enter Policy holder details

What will this be used for?

What do I put here?

Company Policy

Your contact address information

Your contact address information

Your contact address information

Your contact address information

What do I put here?

Let us know about your Home

Please note

Is your home...

Buildings Condition

Residents

Security Details

Buildings cover

Let us know about your belongings

Claim Details

What claims must I declare?

Have you the insured or any person residing with you:

What cover do you require?