Test Commercial Form

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 *

Please advise details? *

CLAIMS:

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

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? *

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? *

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? *

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

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? *

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? *

Do you require cover for loss of rent? *

Current Declared Building Sum Insured *

Do you require contents cover? *

Please advise the amount? *

Date of renewal? *

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

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

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 *

Please advise details? *

CLAIMS:

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

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? *

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? *

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? *

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

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? *

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? *

Do you require cover for loss of rent? *

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

Current Declared Building Sum Insured *

Do you require landlord contents cover? *

Please advise the amount? *

Date of renewal? *

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

Phone

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? *

If Yes, please provide details:

Full Proposer 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

Are there Building/Structures situated on the land? *

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

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

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

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

If yes, please describe the watercourses:

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? *

Property Owners Liability *

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. *

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

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

Comment

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

Date of Renewal

Phone

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? *

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

have composite panelling?

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?

Has a flat roof?

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

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

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)

How many garages are you insuring?

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

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

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

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

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.

Message

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) *

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 *

Name

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

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

Please advise the date of loss, type of claim and 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? *

Year of Build *

Are you insuring the whole property? *

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 property have a cellar or basement? *

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? *

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

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? *

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

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

What is the Declared Buildings Sum Insured (the lower figure on your current renewal schedule if you have one)? *

Do you require cover for loss of rent? *

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? *//

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

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 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 *

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?: *

Please advise the date of loss, type of claim and 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? *

What type of property are you insuring? *

Please advise the type of property? *

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? *

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? *

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

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? *

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

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

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

Agree

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.

Phone

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

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

Please advise the date of loss, type of claim and 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? *

Year of Build *

Are you insuring the whole property? *

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 property have a cellar or basement? *

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? *

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

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? *

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

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

What is the Declared Buildings Sum Insured (the lower figure on your current renewal schedule if you have one)? *

Do you require cover for loss of rent? *

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? *//

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

Phone

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? *

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

Please advise details? *

Claims:

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

Please advise the date of loss, type of claim and 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? *

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? *

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? *

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

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? *

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

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

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

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

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

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

Do you require communal contents cover? *

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

Please advise the amount? *

Date of renewal? *

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

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:

Claims at these premises *

If yes to any of the above please give details?

Do you work from home? *

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

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

Year of Build *

Does the property have a flat roof? *

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? *

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? *

Comment

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? *

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

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

Please advise the date of loss, type of claim and 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? *

Declared Building Reinstatement Cost *

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? *

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? *

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

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? *

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

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

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

Name

Callback Request

Name: *

Contact No: *

Type of Insurance: *

Suitable time for callback *

Name

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