Building and Contents Insurance Enquiries

Please complete the form below.

Name:
Address:
Postcode:  
Telephone:
Fax:
Email:
Date of Birth:
Type of Cover:

Buildings   Contents   
Buildings and Contents   Home Office

Cover Required:

 

Buildings Cover Required £:

Accidental Damage Cover Buildings

Contents Cover Required £: (Minimum £15,000)

Accidental Damage Cover Contents

 
Valuables in the home:

Valuables £: Valuables means:

gold silver and other precious metals, jewellery, watches, photographic equipment, works of art, curios, furs, musical instruments, radios televisions, other audio, Hi Fi or video equipment, internal satellite equipments and computer equipment.
Freezer
 
Valuables:

Unspecified Personal Possessions  (cover away from home) £:
Largest Single Item Value Covered Under Personal Possessions  £:

 
Cycles
Money/ Credit Cards
General Details

Property Type £:

Standard Construction : (if NO please give details)

Date Built:

No. of Bedrooms:

NACOSS Approved Alarm :

No. of claims in the last six years (please give details):

Notes (Special Requirements or Disclosures)

I have read, understood and agree to the Data Protection Declaration
I agree to further contact as decribed in Our Future Relationship