Household Insurance Quote

TitleMrMrsMissMsDr

Initial(s)*

Surname*

Address 1*

Address 2

Address 3

Town/City

Postcode*

County

Daytime Tel No.*

Email*

Date of Birth

Occupation

First Time Buyer?noyes

About Your Property

Property TypeDetached HouseSemi-Detached HouseTerraced HouseEnd Of Terrace HouseMaisonetteDetached BungalowSemi-Detached BungalowFlat - Ground Floor or BasementFlat - 1st Floor or Above

No. of Bedrooms12345More Than 5

Period BuiltPre 18371837 - 19191920 - 19451946 - 19791980 - 19891990 Onwards

Standard Constructionyesno

If the property is not of a standard construction, please specify details of construction, and tell us if your property is thatched.

Previous Claims

Have you had any claims within the last 3 years?noyes

If yes, please provide details of any claims including dates, type of claim and cost

Sums Insured

Building (re-instatement cost, not purchase price)

Content (Replacement Costs)

Unspecified All Risks miscellaneous items up to £1000 each)

Specified All Risks (Specified items, each valued over £1000)

Item 1 / Value

Item 2 / Value

Item 3 / Value

Item 4 / Value

Item 5 / Value

Is accidental damage cover required?yesno

Is subsidence cover required?yesno

Additional Details

Name of present insurers

Renewal Date

Premium Paid Last Year

Please leave this field empty.