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Platinum ReferralsRobert Fisher2026-07-14T15:40:38+00:00

✓Originally published November 5, 2018 · Last updated July 14, 2026

Please fill in the form below or call us on 028 9182 8899.

Client Name/s:

Email: Name/s: etc.

Contact No:

Email:

Type of Insurance they are interested in:

Any other information on the referral including previous insurer, etc.

Website

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This question set is tailor-made for Commercial Flood Insurance. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday

Name of Policyholder or Management Company? *

Name of Contact? *

Email Address? *

Best Contact Number? *

property heavy Layout

Postcode of the property to be insured? *

1st line of address (including number or name) of the property to be insured? *

Full postal code of the RISK address and first line of the RISK address is required

Is the property within 50 metres of a lake? (Don’t answer ‘yes’ for rivers, streams or other water sources) *

Yes
No

(Don’t answer ‘yes’ for rivers, streams or other water sources)

What is your relationship with the property?

Owner Occupier
Owner Letting
Tenant

Specify the property’s main usage: *

Agricultural
Commercial
Industrial
Residential
Other

If other, please describe below:

What are the external walls of the property made from? *

Brick/masonry
Concrete/reinforced concrete
Glass
Steel
Stone
Wood/timber
Other

If other, please describe below:

Is any part of the property under construction? *

Yes
No

How many floors are there in the property? *

The number of floors in the property

Are there any floors below ground level? *

Yes
No

Multiple Choice *

Ground Floor Full Top
Ground Floor ½ Top, ½ Bottom
Ground Floor ½ Gully, ½ Bottom
Ground Floor full Gully

Are there any flood resilience measures at the property? *

Yes
No

If yes, please select all options that apply

Air Bricks
Automatic Flood Doors
Barriers
Non-return valves (NRVs)
Pumps
Other

Building Sum Insured *

Yes or No? *

Yes
No

Please state the amount to be insured ie: £300,000 *

Contents Sum Insured *

Yes or No? *

Yes
No

Please state the amount to be insured ie: £150,000 *

Business Interruption *

Yes or No? *

Yes
No

Please state the amount to be insured ie: £80,000 *

Any there any high value items within any contents? (vehicle, heavy machinery) *

Please provide the value *

Do you have any flood cover currently in place? *

Yes
No

Flood History over last 10 years, please include the costs and dates

I confirm I have understood the questions above and that the details I have provided are accurate *

Yes
No

Name

Any Questions or if you need a quote immediately call us on 0800 085 3761 during normal office hours

Policyholder Name:

Email Address *

Contact Number *

Postcode of the buildings: *

Type of Lift - Name of Manufacturer *

Number of floors in the property *

Maximum number of passengers held by the lift *

Date installed *

Additional Information: Any further information or material facts you should or would like to advise Underwriters?

I confirm I have understood the questions above and that the details I have provided are accurate *

Yes
No

by Name the

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions

Website

Cyber Insurance

This question set is tailor made for Cyber Insurance. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday star

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

questions it? Policyholder?

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

Yes/No declaration *

Yes
No

Please advise details? *

CLAIMS:

e) ever had any claims or incidents at these or any other premises in the last 5 years? *

Yes
No

Please advise date of loss, type of claim & total cost of claim? *

1st line of the business address (including the number) of the business to be insured? *

Postcode of the business to be insured? *

What type of business is it? *

Does your business carry out work outside the UK? *

Yes
No

Any claims in relation to this type of insurance in last 5 years? *

Yes
No

Any Convictions/Bankruptcies/Liquidations? *

Date of renewal? *

I confirm I have understood the questions above and that the details I have provided are accurate: *

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

Comment

This question set is tailor made for Holiday Homes or Second Homes. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday star

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

Yes/No declaration *

Yes
No

Please advise details? *

CLAIMS:

e) ever had any claims or incidents at these or any other premises in the last 5 years? *

Yes
No

Date a What

Please advise date of loss, type of claim & total cost of claim? *

1st line of the address (including the number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole building? *

Yes
No

What type of property are you insuring? *

Is the property a HOLIDAY HOME (let), SECOND HOME?

Type of Tenancy (if applicable) *

Please advise tenant type? *

Does the property have a basement or cellar? *

Yes
No

How many floors are in the building including basement/cellar and floor construction of each floor (e.g. wood, concrete or mixture)? *

How many bedrooms are in the property? *

Is the building constructed only with walls built or brick, stone or concrete? *

Yes
No

Does the building have a pitched roof constructed only of slate, tiles or metal? *

Yes
No

Is there a Garage at the premises? *

What is the construction of the roof of buildings (e.g. felt on timber) and percentage of flat roof if there is one(1-100%)? *

What type of fixed heating is in the property? *

Please advise type? *

Year of Build? *

Is the building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and the type of waterway? *

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

Do you require cover for loss of rent? *

Yes
No

Current Declared Building Sum Insured *

Do you require contents cover? *

Yes
No

Please advise the amount? *

Date of renewal? *

I confirm I have understood the questions above and that the details I have provided are accurate:

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

Email

Any Questions or if you need a quote immediately call us on 0800 085 3761 during normal office hours

Name (required) *

Contact No (required) *

Email *

Risk Address Postcode *

First line of Address *

Location Type *

Location Use *

Current Declared Building Sum Insured *

Loss of Rent (if required)

Alternative Accommodation (if required)

Public Liability - £2m or £5m (if required)

Year of Build

required) of of

Date of Renewal

Any Questions or if you need a quote immediately call us on 0800 085 3761 during normal office hours

Contact Name (required) *

Contact No (required) *

Start Date (or Renewal Date) *

Email *

Trading Name (eg. Joe Smith t/as Plumbing Solutions or Plumbing Solutions Ltd)

Postcode & 1st Line of Address (registered business) *

cover? Name 3

Year business established *

Type of Trade *

Years of experience you have in your trade *

Max height work is carried out (metres)

leave if not applicable

Max depth work is carried out (eg Plumbers)

leave if not applicable

Any Employees?

If Yes, what is estimated Wage Roll over next 12 months?

leave if not applicable

Annual Turnover *

Do you require any extra cover? (eg Tools Cover, phase 3 electrical for electricans, hired in plant etc)

Thank you for completing the form. We will reply to you shortly with a premium indication which may be subject to change if you are unable to agree with any assumptions we have made. Please confirm you agree by checking the box below *

Yes
No

Website

This question set is tailor made for homes which are owner occupied and this type of insurance is classed as 'Household Insurance'. Cover for buildings, contents and personal possessions can be provided. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday

Name of Policyholder? *

Policyholder's Date of Birth? *

Policyholder's Occupation? *

Email Address? *

Best Contact Number? *

1st line of the address (including number / name) of the property be insured including the postcode? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?
b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?
c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?
d) disqualified from being a company director?
e) had any Claims at these or any other premises in the last five years?

Claims at these premises *

Yes
No

If yes to any of the above please give details?

Do you work from home? *

Yes
No

Is the property standard construction (walls built only of brick, stone or concrete & roofed with slate, tile or concrete)? *

Yes
No

Type of Build (Detached house, Semi, Mid-Terraced, End-Terraced, Flat, Bungalow etc) *

Year of Build *

what the Build

Does the property have a flat roof? *

Yes
No

If yes, what is the construction (e.g. felt on timber)?

Number of bedrooms? *

Number of bathrooms (which have a bath or shower)? *

Has the property been extended? *

Yes
No

If yes, what year was the extension built?

What type of fixed heating is in the property (e.g. gas, electric, oil etc)? *

Building Sum Insured? *

Contents Sum Insured? *

Any specified items (items of value you would like to insure away from the home - list below with their value and details)? *

Are there any paying guests? *

Yes
No

I confirm I have understood the questions above and that the details I have provided are accurate. *

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

Message

Any Questions or if you need a quote immediately call us on 0800 085 3761 during normal office hours

Has the Proposer ever: a) Ever had insurance cover refused or cancelled or special terms imposed? b) Ever been convicted or cautioned with any criminal offence, other than driving offences? c) Ever had any claims or incidents at this or any other business in the last 5 years? d) Ever been declared bankrupt or been the subject of any winding up petition or order in this or any previous businesses? e) Ever been disqualified from being a company director? f) Had a County Court Judgement or Sherrif Court Decree? *

Yes
No

If Yes, please provide details:

Your Name: *

Full Proposer Name (This is the INSURED name as it would read on the Policy - IF this is a Management Company responsible for example, please enter this & not an Individual's Name): *

Email Address *

Contact Number *

Postcode of where land is situated: *

Address of where land is situated: *

Size of the land *

Up to 2 acres
Up to 5 acres
Up to 10 acres
Up to 20 acres
Up to 45 acres
Over 45 acres

Type of land *

Development site
Grazing, Moorland or Woodland
Moorland
Rough Country
Self-build
Undeveloped Pasture
Private Road
Allotments
Fishing Lakes (without boat hire)
Fishing Lakes (including boat hire)
Car Parks (up to 50 spaces)
Car Parks (up to 100 spaces)
Car Parks (up to 150 spaces)
Car Parks (up to 200 spaces)
Car Parks (over 200 spaces)

Are there any Footpaths or Rights of Way? *

Are there Building/Structures situated on the land? (Anything constructed or erected with a Fixed Location on the ground, excluding fences, gates & boundary walls) *

Yes
No

If ‘yes’ to above - Is the landowners liability to extend to these buildings? *

Yes
No
N/A (no building)

If ‘yes’ to above – Are there any Unoccupied buildings/structures on the land to be insured? *

Yes
No
N/A (no building)

If ‘yes’ to above - Are the unoccupied buildings structurally sound and in a secure area, not accessible to the public? *

Yes
No
N/A (no building)

Are there any watercourses or significant water features within the land to be insured or adjacent? *

Yes
No

Is the Land used for any Boating, Fishing or the Mooring of boats? *

Has or was the land to be insured used or ever used, by any Petrol Station, Chemical Works, Gas Works, Oil Refineries, Power Stations, Underground Mines or any other industries of this nature? *

Yes
No

Property Owners Liability *

of Yes,

Additional Information: Any further information or material facts you should or would like to advise Underwriters?

Claims or Incidents: Have you sustained any loss or had any claim made against you, whether insured or not, in respect of any of the covers required under this policy or any other policy or any previously occupied premises during the last 5 years? Any claims within the last 5 years. *

Yes
No

I confirm I have understood the questions above and that the details I have provided are accurate *

Yes
No

We will contact you by phone to indicate your premium during business hours or the next working day. We will only provide a Quote if one of the below slots is selected & we speak with you. *

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions

Email

on wider the

Name of Policyholder? *

Best Contact Number? *

Email Address? *

1st line of the address (including number) of the property to be insured? *

Postcode of the property to be insured? *

Have you:

a) ever had any Insurance cover refused or cancelled or special terms imposed?

b) ever been convicted or cautioned with any criminal offence, other than driving offences?

c) ever had any claims or incidents relating to this or any other business in the last 5 years?

d) ever been declared bankrupt or been the subject of any winding up petition or order in this or any or any previous business?

e) been disqualified from being a company director?

f) had a County Court Judgement or Sheriff Court Decree?

Have you ever? *

Yes
No

If yes to any of the above, please advise?

What year did the Insured first own these premises?

Year of Build *

Is the Building to be insured:

in a good state of repair *

Yes
No

have composite panelling? *

Yes
No

Is the building built of brick, stone, metal or concrete and roof made with slate, tiles, metal, concrete or flat roofed with asphalt, bitumen or concrete? *

Yes
No

Has a flat roof? *

Yes
No

What is the roof constructed off? E.g. Slates, tiles, flat felt *

It is a condition precedent to liability that any felted roof portion of the Premises shall have been inspected at least once every two years by a qualified builder or property surveyor and any defects brought to light by that inspection shall be repaired immediately.

Has the premises ever suffered from:

Flooding or in an area troubled by flooding? Please note that flood cover is only available if the property is fully occupied or wider perils have been selected *

Yes
No

Subsidence, landslip or heave or in an area troubled by subsidence, landslip or heave? *

Yes
No

If you answered yes to any of the above please advise in box below:

Is the property currently in use? (Please note in use means being actively used for storage or other purposes and attended on a regular basis) *

Yes
No

How many garages are you insuring? *

If more than one garage are they all connected under the one building?

Yes
No

Building Sum Insured: (we DO NOT insure contents in a garage) *

Property Owners Liability: *

£2,000,000
£5,000,000

Is the garage owner occupied or do you rent it out? *

Owner Occupied
Rented out

Is the Premises used for any Business Purposes? (other than letting) *

Is the Premises a Commercial Unit or Converted Dwelling? *

Have you had any claims/incidents at these or any other premises within the last 5 years? *

No
Yes

If Yes to the above, please advise date of loss, type of claim & settlement figure

Date of Renewal (or date cover required)? *

We will contact you by phone to indicate your premium during business hours or the next working day. We will only provide a Quote if one of the below slots is selected & we speak with you. *

Phone

This question set is tailor made for Residential Properties which are occupied by tenants. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday star

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

Yes/No declaration *

Yes
No

Please advise details? *

CLAIMS:

e) ever had any claims or incidents at these or any other premises in the last 5 years? *

Yes
No

Please advise 1. Date of loss, 2. Type of claim (Malicious Damage for example) & 3. Total cost of claim? *

1st line of the address (including the number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole building? *

Yes
No

What type of property are you insuring? *

Please advise type of property? *

State fully the tenant who occupies the property? *

Please advise tenant type? *

Is the Property an HMO? *

Does the property have a basement or cellar? *

Yes
No

How many floors are in the building including basement/cellar and floor construction of each floor (e.g. wood, concrete or mixture)? *

How many bedrooms are in the property? *

Is the building constructed only with walls built or brick, stone or concrete? *

Yes
No

Does the building have a pitched roof constructed only of slate, tiles or metal? *

Yes
No

What is the construction of the roof (e.g. felt on timber) and percentage of flat roof (1-100%)? *

What type of fixed heating is in the property? *

Please advise type? *

Year of Build? *

Is the building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and the type of waterway? *

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

Do you require cover for loss of rent? *

Yes
No

Please advise the amount required and indemnity period (e.g. 12, 24 or 36 months)? *

Current DECLARED Building Sum Insured (We cannot Quote without this) *

Do you have a current Valid Electrical Certificate? *

Do you require landlord contents cover? *

Yes
No

walls concrete brick,

Please advise the amount? *

Date of renewal? *

Do you have any Vulnerability? (ie. Bereavement, Disability, Eyesight, English not First Language, Financial, Family Member Sickness, Old Age, Terms not Offered)

Do you live in United Kingdom of Great Britain & Northern Ireland? *

Target Premium (We are a Broker and will ALWAYS pass on the best premium our insurers quote to you, whatever your premium! Giving us a Target, however, allows us to negotiate with Insurers if their offer is too high. Without a Target, we may offer a premium we think is competitive but might be higher than your current offer. A Target will normally mean we can obtain discount from Insurers that would not have been previously agreed by Insurers). *

I confirm I have understood the questions above and that the details I have provided are accurate:

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

We will contact you by phone to indicate your premium. We will only provide a Quote if one of the below slots is selected & we speak with you. *

Name

This question set is tailor made for Unoccupied Residential Properties awaiting sale / let or undergoing works. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

Agree to declaration *

No
Yes

Please advise details? *

Claims - Have you ever had any claims or incidents at these or any other premises in the last 5 years?:

Claims - Have you ever had any claims or incidents at these or any other premises in the last 5 years?: *

Yes
No

Please advise 1. Date of loss, 2. Type of claim and 3. Total Cost of claim? *

Property Details:

1st line of the address (including number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole building? *

Yes
No

What type of property are you insuring? *

How long has the property been unoccupied? *

What are the plans for the property? *

Type of renovation works, cost of works and timescale of works? *

Does the property have a basement or cellar? *

Yes
No

How many floors are in the building including basement/cellar & floor construction of each floor (e.g. wood, concrete or mixture)? *

How many bedrooms are in the property? *

Is the building constructed only with walls built of brick, stone or concrete? *

Yes
No

Does the building have a pitched roof constructed only of slate, tiles or metal? *

Yes
No

What is the construction of the roof (e.g. felt on timber) and percentage of flat roof (1-100%)? *

What type of fixed heating is in the property? *

property building to

Please advise type? *

Year of build? *

Is the building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and type of waterway? *

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

DECLARED Building Sums Insured (the lower figure on your current renewal schedule)? *** We cannot Quote without this *** *

Date of renewal? *

I confirm I have understood the questions above and that the details I have provided are accurate

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions.

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

Email

This question set is tailor made for Commercial Properties with a wide range of trades occupying the premises whether owner occupied or let. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday star

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

First Question A, B, C & D

Yes
No

Please advise details? *

CLAIMS

e) ever had any claims or incidents at these or any other premises in the last 5 years?

1st Question E

Yes
No

Please advise 1. Date of loss, 2. Type of claim (ie. Theft, Fire, Storm for example) and 3. Total cost of Claim? *

PROPERTY DETAILS

1st line of address (including number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole property? *

Yes
No

State fully the occupant(s) and their trade(s) in respect of each floor of the building including any basement/cellar (including residential tenants)? *

Does the Policyholder occupy any part of the building? *

Does the property have a cellar or basement? *

Yes
No

How many floors are in the building including basement/cellar and the floor construction of each floor (e.g. concrete, wood or mixture)? *

Is the Building constructed only with walls built of brick, stone or concrete?

Yes
No

If you have answered 'no', please advise the construction type

Does the Building have a pitched ROOF constructed only of slate, tiles or metal? *

Yes
No

If there is a Flat Roof, what is its construction (e.g. felt on timber, concrete) and the % which is flat (0-100%)? *

Does the building have any Composite Panels? *

No
Yes

What type of fixed heating is in the property? *

which quote E

Please advise type? *

Year of Build? *

Is the Building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and type of waterway? *

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

What is the Declared Buildings Sum Insured (the lower figure on your current renewal schedule)? ** We cannot Quote without a Sum Insured*** *

Do you have a current Valid Electrical Certificate? *

Do you require cover for loss of rent? *

Yes
No

Please advise the amount required and the indemnity period (e.g. 12, 24 or 36 months)? *

Do you require landlords contents cover? *

Please advise the amount? *

Date of Renewal? *

Target Premium - (We are a Broker and will ALWAYS pass on the best premium our insurers quote to you, whatever your premium! Giving us a Target, however, allows us to negotiate with Insurers if their offer is too high. Without a Target, we may offer a premium we think is competitive but might be higher than your current offer. A Target will normally mean we can obtain discount from Insurers that would not have been previously agreed by Insurers). *

I confirm I have understood the questions above and that the details I have provided are accurate

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

We will contact you by phone to indicate your premium during business hours or the next working day. We will only provide a Quote if one of the below slots is selected & we speak with you. *

Message

This question set is tailor made for Blocks of Flats that are owner occupied, part owner occupied / part let, & fully let. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday

Name of Policyholder or Management Company? *

Name of Contact? *

Email Address? *

with walls Name

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?
b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?
c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?
d) disqualified from being a company director?

General Declaration

Yes
No

Please advise details? *

Claims:

e) ever had any claims or incidents at these or any other premises in the last 5 years?

Yes
No

Please advise the 1. Date of loss, 2. Type of claim (ie. flood or accidental damage for example) and 3. Total cost of claim? *

Property Details:

1st line of address (including number or name) of the property to be insured? *

Full postal code of the RISK address and first line of the RISK address is required

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole property? *

Yes
No

Please select the type of property to be insured: *

How many flats are there in the block? *

The number of individual flats within the building

Please advise the tenant type per flat (e.g. 1 owner occupied, 1 student, 1 unoccupied, 1 council support - direct tenancy between landlord and tenant etc)? *

Does the property have a basement or cellar? *

Yes
No

How many floors are in the building including basement/cellar? *

What is the floor Construction? (Concrete, timber, mixture of both) *

Is the building constructed only with walls built of brick, stone or concrete? *

Yes
No

Does the building have a pitched roof only & constructed of slate, tile or metal? *

Yes
No

Is there any cladding? *

If there is cladding, please advise full details & if it is fire approved

What is the construction of the Flat Roof? (Eg. Felt on Timber) & the % of the total Roof area? *

What type of fixed heating is in the property? *

Please advise type of heating? *

Year of build? *

Is the building listed? *

Do you have a current Valid Electrical Certificate? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and type of waterway? *

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

What is the Declared Building Sum Insured (eg. £100,000, £500,000 or £1,000,000 etc - We cannot Quote without this)? *

Do you require loss of rent or alternative accommodation cover? *

Yes
No

Please advise the amount required, indemnity period (e.g. 12, 24 or 36 months) and type of cover? *

Do you require communal contents cover? *

Yes
No

Please advise the amount Contents Cover required (£)? *

Do you require a Lift Inspection Policy? (if applicable)

Yes
No

Date of renewal? *

Target Premium - (We are a Broker and will ALWAYS pass on the best premium our insurers quote to you, whatever your premium! Giving us a Target, however, allows us to negotiate with Insurers if their offer is too high. Without a Target, we may offer a premium we think is competitive but might be higher than your current offer. A Target will normally mean we can obtain discount from Insurers that would not have been previously agreed by Insurers). *

I confirm I have understood the questions above and that the details I have provided are accurate *

Yes
No

We will contact you by phone to indicate your premium. We will only provide a Quote if one of the below slots is selected & we speak with you. *

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

Name

Get an insurance quote for…

Can’t find the insurance you are looking for?

Give us a call on 0800 085 3761

This question set is tailor made for Unoccupied Commercial Properties awaiting sale / let or undergoing works. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

the the concrete?

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

First Question A, B, C & D

Yes
No

Please advise details? *

CLAIMS

e) ever had any claims or incidents at these or any other premises in the last 5 years?

1st Question E

Yes
No

Please advise 1. Date of loss, 2. Type of claim (Storm for example) and 3. Total cost of claim? *

1st line of the address (including number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole building? *

Yes
No

DECLARED Building Reinstatement Cost (We cannot quote without this) *

State fully the occupant(s) and their trade(s) prior to the property becoming unoccupied? *

How long has the property been unoccupied? *

What are the plans for the property? *

Type of renovation works, cost of works and timescale of works? *

Does the property have a basement or cellar? *

Yes
No

How many floors are in the building, including the basement/cellar and floor construction of each floor (e.g. wood, concrete or mixture)? *

Is the property constructed only with walls built of brick, stone or concrete? *

Yes
No

Does the building have a pitched roof, constructed only of slate, tiles or metal? *

Yes
No

What is the construction of the roof (e.g. felt on timber) and the percentage of flat roof (1-100%)? *

What type of fixed heating is in the property? *

Please advise type: *

Year of build? *

Is the building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and type of waterway? *

Is the property in an area which has any history or subsidence or flooding? *

Yes
No

What is the declared building sums insured (the lower figure on your current renewal schedule)? *

Date of renewal? *

I confirm I have understood the questions above and that the details I have provided are accurate

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

We will contact you by phone to indicate your premium during business hours or the next working day. We will only provide a Quote if one of the below slots is selected & we speak with you. *

Website

Get an insurance quote for…

unoccupied commercial property insurance

Can’t find the insurance you are looking for?

Give us a call on 0208 651 3131

This question set is tailor made for Commercial Properties with a wide range of trades occupying the premises whether owner occupied or let. To help us provide you with a personalised quote, please fill out the form below:

Any questions or if you need a quote immediately call us free on 0800 085 3761 between 9am-5pm, Monday to Friday star

Name of Policyholder? *

Name of Contact? *

Email Address? *

Best Contact Number? *

Has the Proposer(s), or any Partner(s) or Director(s) ever been:

a) convicted, cautioned or currently have any prosecutions pending against them regarding any criminal offence, other than a motoring offence?

b) refused insurance, had special conditions imposed by an Insurer, had any insurance terminated or been refused renewal of such insurance?

c) declared bankrupt, or had a company become insolvent or voluntarily gone into liquidation or Compulsory liquidation?

d) disqualified from being a company director?

First Question A, B, C & D

Yes
No

Please advise details? *

CLAIMS

e) ever had any claims or incidents at these or any other premises in the last 5 years?

1st Question E

Yes
No

Please advise 1. Date of loss, 2. Type of claim (ie. Theft, Fire, Storm for example) and 3. Total cost of Claim? *

PROPERTY DETAILS

1st line of address (including number) of the property to be insured? *

Postcode of the property to be insured? *

How long have you owned the property? *

Are you insuring the whole property? *

Yes
No

State fully the occupant(s) and their trade(s) in respect of each floor of the building including any basement/cellar (including residential tenants)? *

Does the Policyholder occupy any part of the building? *

Does the property have a cellar or basement? *

Yes
No

How many floors are in the building including basement/cellar and the floor construction of each floor (e.g. concrete, wood or mixture)? *

Is the Building constructed only with walls built of brick, stone or concrete?

Yes
No

If you have answered 'no', please advise the construction type

Does the Building have a pitched ROOF constructed only of slate, tiles or metal? *

Yes
No

If there is a Flat Roof, what is its construction (e.g. felt on timber, concrete) and the % which is flat (0-100%)? *

Does the building have any Composite Panels? *

No
Yes

What type of fixed heating is in the property? *

Please advise type? *

Year of Build? *

Is the Building listed? *

Is the property more than 250 metres away from the nearest river, canal, lake or tidal waterway? *

Yes
No

Please advise the proximity in metres and type of waterway? *

Target, building tidal

Is the property in an area which has any history of subsidence or flooding? *

Yes
No

What is the Declared Buildings Sum Insured (the lower figure on your current renewal schedule)? ** We cannot Quote without a Sum Insured*** *

Do you have a current Valid Electrical Certificate? *

Do you require cover for loss of rent? *

Yes
No

Please advise the amount required and the indemnity period (e.g. 12, 24 or 36 months)? *

Do you require landlords contents cover? *

Please advise the amount? *

Date of Renewal? *

Target Premium - (We are a Broker and will ALWAYS pass on the best premium our insurers quote to you, whatever your premium! Giving us a Target, however, allows us to negotiate with Insurers if their offer is too high. Without a Target, we may offer a premium we think is competitive but might be higher than your current offer. A Target will normally mean we can obtain discount from Insurers that would not have been previously agreed by Insurers). *

I confirm I have understood the questions above and that the details I have provided are accurate

Yes
No

We will revert back with an indication of your premium - please note this may be subject to change or become invalid if you cannot agree to some conditions. Please note all quotes are based on building being in good state of repair and buildings not being exposed to any flooding, storm damage and free from signs of subsidence.

We will contact you by phone to indicate your premium during business hours or the next working day. We will only provide a Quote if one of the below slots is selected & we speak with you. *

Website

Callback Request

Name: *

Contact No: *

Type of Insurance: *

Suitable time for callback *

Suitable callback of

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