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Please enter the company details

Name

Effective Date of Birth

Used for ratings that require a policyholder age

Are any of the Directors considered to be a Politically Exposed Person?

A "PEP" is someone who has a prominent position in life which gives them the power to make or influence major decisions ie an MHK or a Chief Executive of a large company.

Not yet known

Yes

Details

Company Structure

Registration Number

Address

Telephone Number

Email Address

Additional policyholder data

No items have been added

Add Item

Please enter the date you'd like the policy to start from in dd/mm/yyyy format

Start Date

Please enter the date you'd like the policy to start from in dd/mm/yyyy format

Main Policyholder

Ever been convicted (or charged but not yet tried) of any criminal offence, or received a police caution?

Not yet known

Yes

Conviction details

Been refused insurance or had special terms or conditions applied by an insurer?

Not yet known

Yes

Insurance refusal details

Have you or any member of your family living with you had any insurer decline, cancel or declare void insurance or impose special terms?

Not yet known

Yes

Details

Occupants

Details about the property occupants

Is the property to be let out?

Not yet known

Yes

Do you have any lodgers?

Not yet known

Yes

Do you foster children?

Not yet known

Yes

Flood history

Details about flooding and drainage

Has the property, including gardens, ever been flooded?

Not yet known

Yes

Is the property within 50 metres of the sea, a river, stream or other water course?

Not yet known

Yes

Proximity to water details

Subsidence history

Details about subsidence and movement

Are there any signs of damage from subsidence, settlement, landslip or heave?

Not yet known

Yes

Property movement details

Has any of the property been underpinned or provided with other structural support?

Not yet known

Yes

Property underpinning / structural support details

Loss / Claim history

Previous claims on insurance policies

Have you sustained any loss, damage or liability claims in the last 3 years, whether insured or not?

Not yet known

Yes

Claim details

No items have been added

Add Claim

Buildings cover

Do you require Buildings Insurance?

Not yet known

Yes

Re-building value insured up to

Do you require Accidental damage cover to your buildings?

Yes

Included as Standard

Contents cover

Do you require Contents Insurance?

Not yet known

Yes

Contents value insured up to

Do you require Accidental damage cover to your contents?

Yes

Included as Standard

Interested Parties

Mortgage or Additional Interest

If you would like to list a mortgage provider as an interested party, please enter their name

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