Beazley Home insurance. questionnaire. risk

Size: px
Start display at page:

Download "Beazley Home insurance. questionnaire. risk"

Transcription

1 Beazley Home insurance questionnaire risk

2

3 IN DECIDING THE PREMIUM AND TERMS ON WHICH TO OFFER THIS INSURANCE, INSURERS RELY ON THE INFORMATION YOU GIVE. YOU MUST TAKE CARE WHEN ANSWERING ANY QUESTIONS BY ENSURING THAT ANY INFORMATION PROVIDED IS ACCURATE AND, TO THE BEST OF YOUR KNOWLEDGE AND BELIEF, COMPLETE. FAILURE TO PROVIDE INFORMATION OR THE PROVISION OF INCOMPLETE OR INACCURATE INFORMATION MAY AFFECT YOUR COVER AND ANY CLAIM YOU MAY MAKE. PLEASE CONTACT YOUR BROKER IF YOU DO NOT UNDERSTAND A QUESTION OR THE NATURE OF THE INFORMATION REQUIRED. PLEASE ANSWER ALL THE QUESTIONS IN FULL AND TICK THE YES/NO BOXES AS APPROPRIATE. 1. Your details Full name (Mr/Mrs/Miss/Ms/Title): Joint proposer: Address: Postcode: Home telephone number: Work telephone number: Mobile telephone number: address: Date of birth: Address of premises to which this insurance is to apply (if different from above): Address: Postcode: PLEASE NOTE: IF MORE THAN ONE PROPERTY IS TO BE INSURED PLEASE COMPLETE A SEPARATE PROPOSAL FORM FOR EACH ADDRESS. Occupation: Please indicate the precise nature of business. It is not sufficient to state Secretary, Salesman, Company Director. Please also state in the space below if this occupation or any occupation of persons resident at the above address is conducted from your home and if so how many business visitors attend the property per week. Proposer: Occupation of partner or spouse (if applicable): Other occupants: Details of all other persons resident at the above address other than members of your family or resident domestic employees, whose property is to be insured: Name Relationship to proposer Occupation/Precise nature of business Interested parties: Please state the name and address of any party whose interest is to be noted under this policy i.e. mortgage lender:

4 2. Your home and its outbuildings The private dwelling at the address to be insured, including outbuildings (garages, stables, barns, studios, pool houses and other similar structures used for domestic purposes). PLEASE NOTE: IF YOU TICK ANY OF THE SHADED BOXES PLEASE PROVIDE FURTHER DETAILS IN THE SPACE AT THE END OF THIS SECTION. 1. Is the home and its outbuildings your main and permanent place of residence? If no, is it one of the following: Holiday home Weekend home Weekday home Let Other: 2. Is the home used for any business, trade or profession? 3. Are the gardens open to the public? Is the home open to the public? Do you hold any public events? Do you have any public rights of way through your property? 4. Is the home regularly unattended, other than during daytime working hours, and/or will it be left unoccupied for periods in excess of 60 days? 5. Are the buildings constructed of: Brick Stone Concrete Other: and roofed with: Slate Tiles Concrete Other: 6. Does the main dwelling have a flat felt or asphalt roof which covers more than 33% of the total roof area? (If yes, please confirm the percentage in the space provided.) Percentage of total roof area: 7. Are the outbuildings (garages, stables, barns, studios, pool houses or similar structures with a rebuild value of 50,000 or greater) constructed of brick, stone, concrete and roofed with slate, tile or concrete?* 8. Is the home in a good state of repair and regularly maintained? 9. How many bedrooms does the property have? 10. Has your home ever flooded? 11. Is your home built in an area historically free from flooding and coastal or river erosion and not within 400 metres of any river, stream or tidal waters? 12. Are the buildings free from signs of damage due to subsidence, heave or landslip (such as internal or external stepped or diagonal cracks), and not in an area where there has been evidence of these occurrences? 13. Are the buildings being monitored for subsidence, heave or landslip; have they ever been monitored for subsidence, heave or landslip, or suffered any subsidence, heave or landslip? 14. Has any survey carried out on your home ever reported settlement or movement of buildings? (If yes, please enclose a copy with this proposal.) 15. Are you aware that any neighbouring buildings have been the subject of an occurrence of subsidence, heave or landslip? 16. Are there any trees or shrubs within 7 metres (22ft.) of your home (whether inside or outside your garden) which are more than 3 metres (10ft.) tall? If yes, are the trees or shrubs within your boundaries? Yes No

5 Yes No 17. State the year the property was built: 18. Are any of the buildings or outbuildings listed? (Please give details and status in the space provided.) 19. Are you currently undertaking or planning to undertake any extensions, renovations or structural work? (If yes, please provide full details including the contract value) 20. Is your home a: Other: Detached house Semi-detached house Mid-terraced house End of terrace Maisonette Flat Bungalow Town house 21. If your home is a flat: Is it self-contained having its own lockable entrance under your sole control? Is it purpose built? Which floor is it on? If you have ticked any of the shaded boxes under Your home and its outbuildings, please give full details in the space below: Question No. Details

6 3. Protection of the premises Please answer the following questions regarding the level of security installed at your property. Yes No 1. Are final exit doors secured by mortice deadlocks (i.e. cut into the wood) with at least 5 levers or a rim deadlock conforming to British Standard 3621 or, if the door(s) are UPVC or double-glazed, a multi-point locking system with either a lever or built-in deadlocking cylinder? 2. Are all other external doors secured by a mortice deadlock (i.e. cut into the wood) or a deadlock conforming to British Standard 3621 or by a multi-point locking system with either a lever or built-in deadlocking cylinder or key-operated security bolts fitted internally to the top and bottom? 3. Are all opening sections of the basement, ground floor and easily accessible windows, fanlights and skylights to the buildings secured by key-operated window locks? 4. Are the premises to be insured fitted with a security alarm? If yes, please give details of the make and model number: 5. Is the alarm maintained under contract by an NSI, SSAIB or BSIA approved installer? Please state the type of alarm installed: Bells only Central station Redcare Digital communicator Packnet Connected to police Other: 6. Do you have a safe installed? If yes, please confirm the make, model number, type (i.e. freestanding, wall or under floor) and cash rating if known: 7. Do you have any of the following installed or in place at the premises to be insured? CCTV installed Infra-red lighting Security gates Building concierge None of these 8. Fire protections: Do you have any of the following in place? Battery or mains-operated smoke alarms If yes, how many? Central station fire/smoke alarms Fire blankets Fire extinguishers 9. Any other security or fire protections please provide details below:

7 4. Statement of values to be insured 1. Buildings The sum insured must represent the full cost of rebuilding your property and its outbuildings in their current form including any professional fees and site clearance. The buildings include all fixtures and fittings, tenant s improvements, fitted appliances, tennis courts, swimming pools, septic tanks, domestic oil or gas tanks, paved terraces, greenhouses, garden sheds, ornamental fountains and ponds, lampposts, house signs, drives, patios, paths, walls, gates, fences and interior decorations all owned by you or for which you are legally responsible. Also included are underground services, sewers, pipes, cables and drains which extend to the public mains. Outbuildings are defined as free-standing permanent structures including garages, stables, barns, studios, pool houses and other similar structures with a rebuild value of 50,000 or over. Tenant s improvements are defined as alterations, decorations or improvements which have been undertaken by you or previous occupiers as tenants but only if not covered by the landlord s or any other insurance. Main property: Outbuildings (if any): Tenant s improvements: Total: 2. Contents Your sum insured must represent the current cost of replacing, as new, your household goods, carpeting, furnishings, outdoor and garden property and other personal property including personal possessions designed to be worn or carried, pedal cycles and clothing belonging to you or for which you are legally responsible. Please ensure that the total sum insured for contents includes any items that fall within the following limits. These sums are included in, and will not increase, the contents sum insured that you request cover for. Certain contents items are limited as follows: Pedal cycles up to 2,500 any one cycle Valuables (jewellery, watches, furs and guns), gold, silver and gold and silver plated items up to 10,000 any one claim. Money up to 5,000 any one claim Credit cards (fraudulent or unauthorised use) up to 25,000 any one claim Outdoor and garden property (Items designed to be left or used outdoors including garden furniture, children s play equipment, statues and ornaments, domestic garden maintenance equipment, golf trolleys, golf buggies, motorised and non-motorised wheelchairs, motorised sit-in toy or miniature vehicles including motor-cycles providing they have an engine capacity of 50cc or less, quad bikes but only if used exclusively for the care of gardens, horses and pets; trailers and non-motorised horseboxes up to 12 ft in length) no more than 15,000 any one claim but no more than 7,500 for trailers, non-motorised horseboxes and ride-on mowers, and no more than 5,000 for quad bikes, motorcycles or golf buggies Business contents (Office furniture and equipment, stationery, office supplies, software, books, records and documents in your home) no more than 25,000 any one claim Wine 25,000 any one claim but no more than 500 for any one bottle Watercraft (Sailboards, surfboards, dinghies, hand-propelled and motorised boats of less than 16 ft in length, motorised watercraft with an engine of 25 horsepower or less including their furnishings, equipment and outboard motors) up to 7,500 any one claim Contents belonging to your parents or grandparents whilst in a nursing or residential care home up to 25,000 any one claim but no more than 2,500 any one item IMPORTANT NOTES TO ASSIST IN COMPLETING SECTION 2 (CONTENTS) IF HIGHER VALUES ARE REQUIRED ABOVE THE STATED CONTENTS LIMITS FOR ITEMS OTHER THAN VALUABLES AND FINE ART AND ANTIQUES PLEASE ADVISE YOUR BROKER. ANY PEDAL CYCLE EXCEEDING THE LIMIT OF 2,500 MUST BE INDIVIDUALLY SPECIFIED AT ITS FULL VALUE. Total of all contents to be insured:

8 3. Fine art and antiques Please only complete this section if you require cover for fine art and antiques. Fine art and antiques are any article of recognised artistic or collectable nature of whatsoever description other than jewellery, watches, furs and guns. This definition includes but is not limited to tapestries, rugs, furniture, paintings, etchings, manuscripts, sculptures, porcelain, gold, silver and gold and silver-plated items, objets d art, contemporary art, clocks and barometers and articles forming part of a collection. Total amounts required for all unspecified items (Items individually valued at less than 25,000.) Antique or designer-made furniture, tapestries, rugs, carpets or similar: Stamp and coin collections: Paintings, drawings, prints, etchings, photographs, books, manuscripts, etc: Sculptures, ornaments, porcelain and glass: Sculptures outside the home: Barometers, clocks, mechanical art and objets d art: Gold, silver, platinum, pewter and plate, precious stones or coins: Other collections or memorabilia (please specify): Unspecified total: All items of fine art and antiques individually valued at 25,000 or over must be specified in full giving a brief description and current market value in the space provided. If you need more space a list should be attached to this proposal together with valuations or purchase receipts (not more than five years old) for all specified items. Details of all fine art and antiques individually valued at over 25,000 to be specified. (Please use a separate sheet if required.) Description Value Specified total: Total of all unspecified and specified fine art and antiques:

9 4. Valuables Please only complete this section if you require a higher amount for jewellery, watches, furs and guns than the 10,000 sub-limit stated in Section 2 (Contents). Total amount required for all unspecified items (Items individually valued at less than 10,000) Watches and jewellery (permanently in a safe in the home): Watches and jewellery (permanently in a bank or safety deposit): All other watches and jewellery: Guns: Furs: Unspecified total: All items, pairs or sets individually valued at 10,000 or over must be specified in full giving a brief description and current market value in the space provided. If you need more space a list should be attached to this proposal together with valuations or purchase receipts (not more than five years old) for all specified items. Details of all valuables individually valued at over 10,000 to be specified. (Please use a separate sheet if required.) Description Value Specified total: Total of all unspecified and specified valuables:

10 5. Excesses Premium reductions may be available if you agree to accept a higher excess (the amount which you will be responsible for paying in the event of each and every claim). The standard excess applicable to this insurance policy in respect of subsidence, landslip or heave is 1,000. If your claim relates to an incident of loss or damage that falls for consideration under more than one section of cover and you have chosen different sectional excesses, it is the highest applicable excess that will be deducted from the total settlement. Please note higher excesses may be automatically imposed either for all claims or for certain perils such as subsidence, Please tick the appropriate box to indicate the excess you require for each section of cover. Buildings: ,000 2,500 5,000 Other Contents/valuables and art and antiques: ,000 2,500 5,000 Other 6. Previous insurance Please give the name of your previous insurer: Expiry date of policy: Total number of years you have held home insurance: Buildings: Contents: 7. Claims history Have you or any member of your family or any other person normally residing at the premises sustained any loss or (at the property to be insured, at a previous address or away from the home), amount and status (settled, declined, outstanding or not claimed for) of any loss or damage below: Type and brief description Date Location Amount Status mm/yy Buildings* Contents* Fine arts* Valuables* Liability* mm/yy mm/yy mm/yy * Please tick which type of cover your loss or damage fell under and if more space is required please use the notes page opposite. Total number of years since your last claim was made: Buildings: Contents: 8. General information Have you or any member of your family or any other person normally residing at the premises: Yes No 1. Had an insurer decline, cancel, refuse to continue, or agreed to continue only on special terms, any insurance? 2. Received a police caution and/or been convicted of or charged with, but not yet tried, for any offence other than a driving offence? 3. Has anyone whose property is to be insured ever entered into a voluntary arrangement with their creditors or been declared bankrupt? If you have answered yes, to 1, 2 or 3 above please give full details below:

11 European Union Disclosure Clause (UK) The parties of this insurance are free to choose the legal system that will apply to it. Unless specifically agreed to the contrary by underwriters, this insurance shall be subject to English law and subject to the exclusive jurisdiction of the courts of England. Data Protection Act 1998 Any information you have provided will be dealt with by us in compliance with the provisions of the Data Protection Act For the purpose of providing this home insurance and handling of any claims which may arise under it, underwriters may need to transfer certain information which you have provided to other parties. By signing this proposal you agree that such transfer(s) may be made. Declaration I/we declare that the information disclosed on this proposal, is to the best of my/our knowledge and belief both accurate and complete. I/we have taken care not to make any misrepresentation in the disclosure of this information and understand that all information provided is relevant to the acceptance and assessment of this insurance, the terms on which it is accepted and the premium charged. You must tell us as soon as possible about any changes in this information you have provided to us which happens before or during any period of insurance. We will tell you if such change affects your insurance and if so, whether the change will result in revised terms and/or premium being applied to your policy. If you do not inform us about a change it may affect any claim you make or could result in your insurance being invalid. I understand that the signing of this proposal does not bind me to complete the insurance but agree that should a contract of insurance be concluded, this proposal and statements made herein, will form the basis upon which cover, premium and terms will be determined. Commencement date of insurance required if accepted: Signature of proposer(s): Expiry date: Date: No cover is in force until this proposal is accepted by the insurer and the premium is paid. The insurer reserves the right to decline any insurance proposal or to offer different premium and terms from those quoted dependent on the information you have provided. Notes

12 CBPG086_UK_07/14

Home Insurance Proposal Form

Home Insurance Proposal Form Home Insurance Proposal Form Home Insurance Proposal Form Proposal Form There are conditions, limitations, exclusions and excesses within the wording, a copy of which will be provided on request. A copy

More information

Home Insurance Questionnaire Republic of Ireland

Home Insurance Questionnaire Republic of Ireland Home Insurance Questionnaire Republic of Ireland Home Insurance Policy Questionnaire There are conditions, limitations, exclusions and excesses within the wording, a copy of which will be provided on request.

More information

Home Insurance Questionnaire Republic of Ireland

Home Insurance Questionnaire Republic of Ireland Home Insurance Questionnaire Republic of Ireland Home Insurance Policy Republic of Ireland Questionnaire There are conditions, limitations, exclusions and excesses within the wording, a copy of which will

More information

Home Insurance Proposal Form

Home Insurance Proposal Form Home Insurance Proposal Form Introduction You must take care in answering all the following questions which are relevant to us in providing this insurance and setting the terms and premium. Please contact

More information

P A L L A D I U M H o m e I n s u r a n c e P r o p o s a l F o r m

P A L L A D I U M H o m e I n s u r a n c e P r o p o s a l F o r m P A L L A D I U M H o m e I n s u r a n c e P r o p o s a l F o r m P R O V I D I N G P E A C E O F M I N D The Proposer You must take reasonable care to provide complete and accurate answers to all questions.

More information

HIGH VALUE HOUSEHOLD INSURANCE FACT FINDER

HIGH VALUE HOUSEHOLD INSURANCE FACT FINDER HIGH VALUE HOUSEHOLD INSURANCE FACT FINDER Genavco Insurance Limited Michael s House 10-12 Alie Street London E1 8DE Tel: 020 7702 4300 Fax: 020 7702 4585 HVHIFFv1 Page 1 of 1 02/09 HOUSEHOLD INSURANCE

More information

OAK HIGH VALUE HOME INSURANCE PROPOSAL FORM OAK UNDERWRITING PLC

OAK HIGH VALUE HOME INSURANCE PROPOSAL FORM OAK UNDERWRITING PLC OAK HIGH VALUE HOME INSURANCE PROPOSAL FORM OAK UNDERWRITING PLC Guidance Notes for completion of Proposal Form Buildings and tenants improvements Your sums insured must represent the full cost of rebuilding

More information

Holiday Home Insurance PROPOSAL FORM

Holiday Home Insurance PROPOSAL FORM Holiday Home Insurance PROPOSAL FORM Holiday Home Insurance Summary of Cover available There are conditions, limitations, exclusions and excesses within the wording a copy of which will be provided on

More information

Freetime Home Insurance. Proposal Form

Freetime Home Insurance. Proposal Form Freetime Home Insurance Proposal Form Freetime Home Insurance Proposal Form Please read the Policy Summary prior to completing this proposal form. A specimen Policy document setting out full terms and

More information

Home insurance proposal

Home insurance proposal Amlin UK Home insurance proposal The Home Insurance Keyfacts document should be read before you complete this proposal. Please complete all details on this proposal in BLOCK CAPITALS. A. DETAILS OF PROPOSER(S)

More information

Home Insurance Proposal Form

Home Insurance Proposal Form Home Insurance Proposal Form www.towergate.co.uk Please read the Policy Summary prior to completing this application. A specimen Policy document setting out full terms and conditions is also available

More information

Household Insurance Quote Form

Household Insurance Quote Form Household Insurance Quote Form Ref: Babraham 2015 Please complete all of the following information in order for us to provide you with our most competitive quotation. Personal Details: Title: Full Name:

More information

KC Crystal. Home Insurance Proposal Form

KC Crystal. Home Insurance Proposal Form KC Crystal. Home Insurance Proposal Form Household Claims Helpline Open 24 hours a day, 365 days a year 0845 122 3019 Page 2 HH94 Jul 2014 KC Crystal Proposal Form All sections must be completed. If necessary,

More information

Proposal Form Hiscox Overseas 606 Home Insurance

Proposal Form Hiscox Overseas 606 Home Insurance Hiscox Overseas 606 Home Insurance 01 Hiscox Overseas 606 Home Insurance Please read the following questions carefully and answer them all providing additional information where required. If you need more

More information

Overseas 606 Home Insurance Proposal form

Overseas 606 Home Insurance Proposal form Please read the following questions carefully and answer them all providing additional information where required. If you need more space, please provide answers on a separate sheet of paper, clearly highlighting

More information

INSURANCE PROPOSAL FORM

INSURANCE PROPOSAL FORM INSURANCE PROPOSAL FORM NOTE: Please fill in this form carefully. We will use the information you give on this form to decide whether we can insure you and to decide the premium and the conditions of insurance.

More information

Unoccupied Property Insurance Proposal Form

Unoccupied Property Insurance Proposal Form Unoccupied Property Insurance Proposal Form This proposal form is not for use by Consumer Customers It is essential you provide us with ALL MATERIAL FACTS. Failure to disclose any material facts may invalidate

More information

Unoccupied Property Insurance Proposal Form

Unoccupied Property Insurance Proposal Form Unoccupied Property Insurance Proposal Form This proposal form is NOT for use by Consumer Customers It is essential you provide us with ALL MATERIAL FACTS. Failure to disclose any material facts may invalidate

More information

Home Insurance Choices Proposal Form.

Home Insurance Choices Proposal Form. Home Insurance Choices Proposal Form. This policy is provided and administered by Legal & General Insurance. Points to remember when completing this form: You need to fully complete all the sections on

More information

Property Owners Insurance Proposal Form

Property Owners Insurance Proposal Form Property Owners Insurance Proposal Form This proposal form is NOT for use by Consumer Customers It is essential you provide us with ALL MATERIAL FACTS. Failure to disclose any material facts may invalidate

More information

Property Owners Insurance Proposal Form

Property Owners Insurance Proposal Form Property Owners Insurance Proposal Form This proposal form is not for use by businesses or Commercial Entities If you do not answer any questions honestly, accurately or withhold information we may refuse

More information

PROPOSAL FORM. D D M M Y Y Y Y D D M M Y Y Y Y RAINBOW HOME INSURANCE. Points to remember when completing this form: AGENT APPLICANTS

PROPOSAL FORM. D D M M Y Y Y Y D D M M Y Y Y Y RAINBOW HOME INSURANCE. Points to remember when completing this form: AGENT APPLICANTS RAINBOW HOME INSURANCE PROPOSAL FORM. Points to remember when completing this form: You need to fully complete all the sections on this form using BLOCK CAPITALS, which we use to determine whether to offer

More information

Towergate Platinum Home Insurance Proposal Form

Towergate Platinum Home Insurance Proposal Form Towergate Platinum Home Insurance Proposal Form www.towergate.co.uk Platinum Home Proposal Form PLEASE COMPLETE IN BLOCK CAPITALS It is essential that every question is completed and that you give full

More information

me Insurance Proposal for Home Insurance Home Insurance Proposal for Proposal for COSMOS INSURANCE COMPANY PUBLIC LTD HEAD OFFICE

me Insurance Proposal for Home Insurance Home Insurance Proposal for Proposal for COSMOS INSURANCE COMPANY PUBLIC LTD HEAD OFFICE Proposal for Proposal for Proposal for Home Insurance Home Insurance me Insurance COSMOS INSURANCE COMPANY PUBLIC LTD HEAD OFFICE 46, Griva Digeni Avenue, 1080 Nicosia, P.O.Box 21770, 1513 Nicosia Tel:

More information

Home Insurance Proposal Form

Home Insurance Proposal Form Home Insurance Proposal Form Section 1: Personal Details Proposer Joint Proposer/Partner Title: Full Name: Correspondence Address: Postcode: Date of Birth: Occupation: Nature of Business: Day Time Telephone:

More information

R.T. Williams Advantage Home Insurance summary of cover. Underwritten by Zurich Insurance plc

R.T. Williams Advantage Home Insurance summary of cover. Underwritten by Zurich Insurance plc R.T. Williams Advantage Home Insurance summary of cover Underwritten by Zurich Insurance plc Important you should read this Your policy will normally run for 12 months unless you or we choose to cancel.

More information

Underpinned Property Application Form

Underpinned Property Application Form Underpinned Property Application Form Underpinned Property Scheme Insurance for properties which have suffered subsidence and have subsequently been underpinned can prove difficult to arrange within the

More information

PROPOSAL FORM FOR HOME INSURANCE

PROPOSAL FORM FOR HOME INSURANCE United Insurance Company PSC PROPOSAL FORM FOR HOME INSURANCE IMPORTANT NOTES Filling and signing this application form does not automatically result in a contract. Insurance becomes in force once United

More information

FLATS INSURANCE. Proposal Form November 2004 Edition

FLATS INSURANCE. Proposal Form November 2004 Edition FLATS INSURANCE Proposal Form vember 2004 Edition Completing the Proposal Form To apply for the Flats Insurance Policy, complete this Proposal Form in BLOCK CAPITALS using a ball-point pen (blue or black

More information

Camberford Law plc PROPOSAL FORM. Innovative Insurance Solutions Since 1958

Camberford Law plc PROPOSAL FORM. Innovative Insurance Solutions Since 1958 A UNIQUE AND COMPREHENSIVE INSURANCE SCHEME FOR UNOCCUPIED PROPERTY PROPOSAL FORM Camberford Law plc Innovative Insurance Solutions Since 1958 Insurance Brokers Underwriting Agents Authorised and Regulated

More information

THE NEW HOME PROTECTOR EXTRA INSURANCE PROPOSAL FORM

THE NEW HOME PROTECTOR EXTRA INSURANCE PROPOSAL FORM Argus Insurance Agencies Limited La Concorde Tel: +356 2342-2000 Triq Abate Rigord Fax: +356 2342-2190 Ta Xbiex XBX 1121 home@argus.com.mt www.argus.com.mt THE NEW HOME PROTECTOR EXTRA INSURANCE PROPOSAL

More information

HOUSEHOLD INSURANCE PROPOSAL FORM

HOUSEHOLD INSURANCE PROPOSAL FORM HOUSEHOLD INSURANCE PROPOSAL FORM Please read the following questions carefully and answer them all providing additional information where required. Should you require more space please provide answers

More information

Property Owners Proposal Form

Property Owners Proposal Form Property Owners Proposal Form When completing this Proposal Form, ALL sections of the form must be completed. You must disclose all material facts (i.e. information likely to influence the underwriters

More information

Home Solutions Insurance. Proposal form

Home Solutions Insurance. Proposal form Home Solutions Insurance Proposal form Home buildings and contents insurance IMPORTANT Please read before completing this form. Please complete this form in block capitals giving full answers. Tick boxes

More information

HOME INSURANCE APPLICATION FORM

HOME INSURANCE APPLICATION FORM HOME INSURANCE APPLICATION FORM Sesame Insure ref no: Firm name: Please complete this form, remembering to sign and date the Declaration at the end. Write in capital letters and tick the boxes as appropriate.

More information

Landlord Underwriting Guide

Landlord Underwriting Guide Landlord Underwriting Guide Definitions/Excesses The Allianz Landlord Insurance Policy is designed for people who own individual properties or for those who own multiple properties. The Policy provides

More information

R.T. Williams Advantage Home Insurance Underwritten by Zurich Insurance plc

R.T. Williams Advantage Home Insurance Underwritten by Zurich Insurance plc R.T. Williams Advantage Home Insurance Underwritten by Zurich Insurance plc Summary of cover Insurance Brokers Ltd Important you should read this Your policy will normally run for 12 months unless you

More information

Unoccupied Commercial Property Owners

Unoccupied Commercial Property Owners Unoccupied Commercial Property Owners Insurance Schedule Please check this document. This Insurance is subject to the information detailed in this document. The Insured and their insurance intermediary

More information

Your House/Home Plus Application Form Home insurance

Your House/Home Plus Application Form Home insurance Your House/Home Plus Application Form Home insurance Protecting your home and much, much more Aviva offers a choice of two different home insurance policies: Your House and Home Plus. Whichever you have

More information

Commercial Property Insurance Proposal Form

Commercial Property Insurance Proposal Form Please use BLOCK CAPITALS and answer all questions in full Commercial Property Insurance Proposal Form Salisbury House, 81 High Street, Potters Bar, Herts. EN6 5AS Tel: 01707 291 200 Fax: 01707 291 202

More information

Proposal Form. Home Contents Insurance

Proposal Form. Home Contents Insurance Proposal Form Home Contents Insurance 1 HOME CONTENTS INSURANCE Welcome FirstPort Home Contents Insurance With FirstPort Insurance Services you can enjoy peace of mind knowing that your most treasured

More information

Home Insurance Proposal Form

Home Insurance Proposal Form Home Insurance Proposal Form Agent s Name Agent s Number Policy Number te: Please use BLOCK CAPITALS, insert YES or NO where appropriate and initial amendments. Personal Details 1st Proposer Title (Mr,

More information

Lifestyle Home Insurance

Lifestyle Home Insurance Name of insurer Lloyd s Syndicate 2001 managed by Amlin Underwriting Ltd through its service company Amlin UK. Household insurance Policy summary Buildings See Section One of the policy wording pages 11

More information

Home Insurance www.butterfieldbank.ky Butterfield House 68 Fort Street P.O. Box 705 GT Grand Cayman Cayman Islands

Home Insurance www.butterfieldbank.ky Butterfield House 68 Fort Street P.O. Box 705 GT Grand Cayman Cayman Islands Home Insurance About Your Plan Butterfield Bank is a leading financial institution in the Cayman Islands. We offer a comprehensive range of private and commercial banking services to our customers. We

More information

Securus Insurance Limited. Property Owners Proposal Form

Securus Insurance Limited. Property Owners Proposal Form Securus Insurance Limited Property Owners Proposal Form Securus Insurance Limited Unit C2, Airside Enterprise Centre Swords Co Dublin Phone (01) 8074550 Fax (01) 8074553 Email info@securus.ie Web www.securus.ie

More information

SAFEHOME OPTIONS PROPOSAL

SAFEHOME OPTIONS PROPOSAL SAFEHOME OPTIONS PROPOSAL THIS DOCUMENT FORMS THE BASIS OF YOUR CONTRACT This document is a record of the information advised to RSA Insurance Ireland Limited (RSA) for the purposes of concluding a contract

More information

SAFEHOME SELECT PROPOSAL

SAFEHOME SELECT PROPOSAL SAFEHOME SELECT PROPOSAL THIS DOCUMENT FORMS THE BASIS OF YOUR CONTRACT This document is a record of the information advised to RSA Insurance Ireland Limited (RSA) for the purposes of concluding a contract

More information

Prestige Home Insurance. Enhanced cover for higher value homes and luxury lifestyles.

Prestige Home Insurance. Enhanced cover for higher value homes and luxury lifestyles. Prestige Home Insurance Enhanced cover for higher value homes and luxury lifestyles. Protection for luxury lifestyles If you have a high value of home contents and possessions worth more than 100,000 the

More information

AXA Exclusive. Information leaflet Home Buildings and Contents Insurance

AXA Exclusive. Information leaflet Home Buildings and Contents Insurance AXA Exclusive Information leaflet Home Buildings and Contents Insurance February 2016 Contents Why choose AXA Exclusive 3 Features and benefits 3 Important information 7 How much cover do I need? 7 Limits

More information

HOLMAN UNDERWRITING UNOCCUPIED PRIVATE DWELLINGS PROPOSAL FORM

HOLMAN UNDERWRITING UNOCCUPIED PRIVATE DWELLINGS PROPOSAL FORM Holman Underwriting Policies Underwritten at Lloyd s London Underwriting Centre, 3 Minster Court, Mincing Lane, London, EC3R 7DD Tel: 020 7977 8200 E-mail household@holmans.co.uk Fax: 020 7977 8201 HOLMAN

More information

TOGETHER WE CAN FIGHT FRAUD

TOGETHER WE CAN FIGHT FRAUD HOME PROPOSAL FORM Please complete in BLOCK CAPITALS throughout and tick or in the appropriate boxes. 1. Personal Information Title (Mr, Mrs, Miss or other) Full Name I.D Card No. or Passport No. Date

More information

home insurance Policy summary 24 hour claim notification line 0845 001 0043

home insurance Policy summary 24 hour claim notification line 0845 001 0043 home insurance Policy summary 24 hour claim notification line 0845 001 0043 home insurance A tailored approach Our exclusive insurance product offers you the opportunity to tailor a Buildings and/or Contents

More information

Equestrian Property & Property Owners Liability Insurance Proposal Form FOR COMMERCIAL ESTABLISHMENTS & PRIVATE YARDS

Equestrian Property & Property Owners Liability Insurance Proposal Form FOR COMMERCIAL ESTABLISHMENTS & PRIVATE YARDS Equestrian Property & Property Owners Liability Insurance Proposal Form FOR COMMERCIAL ESTABLISHMENTS & PRIVATE YARDS IMPORTANT NOTICE: You are under a duty to disclose to the Insurers all facts likely

More information

Home Advantage Insurance

Home Advantage Insurance Home Advantage Insurance Our Home Advantage policy is designed to provide you with a broad range of cover when insuring the buildings and contents of your home, fine art and valuables. You may insure the

More information

Home Insurance Policy. In association with

Home Insurance Policy. In association with Home Insurance Policy In association with Home Insurance Policy The following summary does not contain the full terms and conditions of the contract which can be found in the insuring document, a copy

More information

HOTELS. Proposal Form November 2004 Edition

HOTELS. Proposal Form November 2004 Edition HOTELS Proposal Form vember 2004 Edition Important Information To apply for the Hotels Insurance Policy, complete this Proposal Form in BLOCK CAPITALS using a ball-point pen (blue or black ink). Insurance

More information

Landlords Insurance. This policy is provided by Legal & General Insurance.

Landlords Insurance. This policy is provided by Legal & General Insurance. UNDERWRITING AUTHORITY GUIDE Landlords Insurance This policy is provided by Legal & General Insurance. This is not a consumer advertisement. It is intended for professional insurance intermediaries and

More information

Let Home Insurance. Introduction. Buildings. Significant features and benefits

Let Home Insurance. Introduction. Buildings. Significant features and benefits Let Home Insurance Introduction Our Let Home insurance policy is designed for owners or leaseholders who let out private houses and flats to tenants and wish to insure the buildings and/or contents. You

More information

Proposal Form for Bespoke Cover

Proposal Form for Bespoke Cover AIR Artists Insurance Policy Developed in conjunction with a n The Artists Information Company, acting on behalf of members of AIR (Artists Interaction and Representation) Proposal Form for Bespoke Cover

More information

BLOCK OF FLATS PROPOSAL FORM SUMMARY OF COVER

BLOCK OF FLATS PROPOSAL FORM SUMMARY OF COVER BLOCK OF FLATS PROPOSAL FORM SUMMARY OF COVER Insurance Corporation s Block of Flats insurance is a modern, convenient policy giving wide cover at a competitive price. It has been designed to meet the

More information

Home Advantage Insurance

Home Advantage Insurance Home Advantage Insurance Our Home Advantage policy is designed to provide you with a broad range of cover when insuring the buildings and contents of your home, fine art and valuables. You may insure the

More information

Jelf Group plc OVERSEAS PERSONAL INSURANCE PROPOSAL FORM

Jelf Group plc OVERSEAS PERSONAL INSURANCE PROPOSAL FORM Jelf Group plc OVERSEAS PERSONAL INSURANCE PROPOSAL FORM effected with Lloyd's through Jelf Insurance Brokers Ltd Clarendon House, 59/75 Queens Road, Reading, RG1 4BN. Tel 44 (0) 118 983 9943/4 Fax 44

More information

Landlords Buildings & Contents Insurance

Landlords Buildings & Contents Insurance Landlords Buildings & Contents Insurance NW Brown Insurance Brokers Landlords policy has been designed to offer a comprehensive buildings and contents insurance. We provide in-house and claims administration

More information

Broker Direct Home Options Policy Summary

Broker Direct Home Options Policy Summary Broker Direct Home Options Policy Summary This policy summary does not contain full details and conditions of your insurance these are contained in your policy documents. Where a heading in UPPERCASE letters

More information

Sauna & Bath House Insurance Presentation/Proposal

Sauna & Bath House Insurance Presentation/Proposal In order to obtain the best possible terms please answer EVERY question in this form. The more information the better the terms. BROKER NAME: BROKER EMAIL: BROKER TELEPHONE: INSURED FULL NAME & TRADING

More information

Steadfast Extra Care and Steadfast Elite Care. Home and Contents Insurance Application

Steadfast Extra Care and Steadfast Elite Care. Home and Contents Insurance Application Steadfast Extra Care and Steadfast Elite Care Home and Contents Insurance Application Steadfast Extra Care and Steadfast Elite Care Home and Contents Insurance Application Form IMPORTANT NOTICES Product

More information

PROPERTY OWNERS INSURANCE PROPOSAL

PROPERTY OWNERS INSURANCE PROPOSAL PROPERTY OWNERS INSURANCE PROPOSAL Please use BLOCK CAPITALS and tick boxes where applicable. Where requested enter further details in the space provided. If there is insufficient space please continue

More information

The policy documentation can also be made available to you in large print, audio or Braille on request via your broker or insurance intermediary.

The policy documentation can also be made available to you in large print, audio or Braille on request via your broker or insurance intermediary. For UK landlords insurance for policy wording reference: LET/0116/PW This Summary This KeyFacts summary does not contain the full terms and conditions of the contract which can be found in the insuring

More information

Camberford Law plc COMMERCIAL COMBINED PROPOSAL FORM (EXCLUDING LIABILITIES) Innovative Insurance Solutions Since 1958

Camberford Law plc COMMERCIAL COMBINED PROPOSAL FORM (EXCLUDING LIABILITIES) Innovative Insurance Solutions Since 1958 A UNIQUE AND COMPREHENSIVE INSURANCE SCHEME FOR THE CLEANING INDUSTRY COMMERCIAL COMBINED PROPOSAL FORM (EXCLUDING LIABILITIES) Camberford Law plc Innovative Insurance Solutions Since 1958 Insurance Brokers

More information

A summary of your cover. Section 1 Buildings cover

A summary of your cover. Section 1 Buildings cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part of the contract between us. The NatWest

More information

Home Sweet Home. Home Insurance. Your cover

Home Sweet Home. Home Insurance. Your cover Home Sweet Home Home Insurance Your cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part

More information

Home Insurance. Our Policy is You

Home Insurance. Our Policy is You Home Insurance Our Policy is You 1 Contents Quick Guide to Home Insurance 2 Why Choose FBD Home Insurance? 4 What is Covered? Buildings 5 What is Covered? Contents 6 Liability Protection 7 Additional Standard

More information

Home insurance. A summary of your cover

Home insurance. A summary of your cover Home insurance A summary of your cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part

More information

Office insurance proposal form

Office insurance proposal form Office insurance proposal form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block letters within the spaces provided. A principal

More information

Home insurance. A summary of your cover

Home insurance. A summary of your cover Home insurance A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part of the contract between

More information

What do I need to know about Home Insurance? What are the Cover Assumptions? What is the policy excess?

What do I need to know about Home Insurance? What are the Cover Assumptions? What is the policy excess? What do I need to know about Home Insurance? Our Home Insurance policy summary documents (accessible below) briefly outline for you the significant features, benefits, limitations and exclusions of our

More information

Paragraph A Loss or Damage What you are covered for:

Paragraph A Loss or Damage What you are covered for: Your Policy Summary Please read this document carefully which provides a summary of cover. It does not show all of the benefits, exclusions or limits. Please refer to your policy booklet and policy schedule

More information

Guide to Home Buildings and Contents Insurance. April 2012

Guide to Home Buildings and Contents Insurance. April 2012 Guide to Home Buildings and Contents Insurance April 2012 ABI GUIDE TO HOME BUILDINGS REPORT AND ON CONTENTS BOARD EFFECTIVENESS INSURANCE 3 What this guide is for and how it works We, the Association

More information

COMMERCIAL COMBINED PROPOSAL FORM

COMMERCIAL COMBINED PROPOSAL FORM COMMERCIAL COMBINED PROPOSAL FORM Incorporating Manufacturing Light Industrial High Risk Property Heavy Industrial Please answer all the following questions for each of the relevant sections as fully as

More information

Selections Proposal form

Selections Proposal form Selections Proposal form High quality insurance for the recruitment industry. Important Note Before completing the proposal form please refer to the summaries of cover. This will assist you to select the

More information

A summary of your cover. Section 1 Buildings cover

A summary of your cover. Section 1 Buildings cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part of the contract between us. The NatWest

More information

A summary of your cover

A summary of your cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part of the contract between us. The Churchill

More information

LetsProtect Extensive cover for landlords

LetsProtect Extensive cover for landlords Countrywide Insurance Services LetsProtect Extensive cover for landlords Proud to be associated with www.countrywide.co.uk Information booklet LetsProtect information booklet Why choose LetsProtect from

More information

Home insurance. A summary of your cover

Home insurance. A summary of your cover Home insurance A summary of your cover A summary of your cover Please read this document carefully. Full terms and conditions can be found within your policy documents. This summary does not form part

More information

Holiday Home Insurance

Holiday Home Insurance Holiday Home Insurance Our holiday home insurance policy is designed to provide you with a wide range of standard cover when insuring the buildings and contents of your holiday home in the United Kingdom.

More information

Pay As You Go Home Contents Insurance

Pay As You Go Home Contents Insurance Pay As You Go Home Contents Insurance Application Peace of mind at an affordable cost # Personal Details PLEASE USE CAPITAL LETTERS WHEN FILLING IN THIS FORM Are you a tenant of Basildon Borough Council?

More information

Your home insurance policy Features and benefits HMP FAB 2014 05 V1.0. FBD Insurance plc is regulated by the Central Bank of Ireland

Your home insurance policy Features and benefits HMP FAB 2014 05 V1.0. FBD Insurance plc is regulated by the Central Bank of Ireland Your home insurance policy Features and benefits HMP FAB 2014 05 V1.0 FBD Insurance plc is regulated by the Central Bank of Ireland FBD has over 40 years insurance experience and today we are one of Ireland

More information

Our landlords policy has been designed to offer a comprehensive buildings and contents insurance.

Our landlords policy has been designed to offer a comprehensive buildings and contents insurance. Our landlords policy has been designed to offer a comprehensive buildings and contents insurance. We provide in-house policy and claims administration to further enhance our ability to rapidly respond

More information

TENANTS CONTENTS INSURANCE MADE SIMPLE

TENANTS CONTENTS INSURANCE MADE SIMPLE TENANTS CONTENTS INSURANCE MADE SIMPLE in association with Sandwell Metropolitan Borough Council has negotiated a Home Contents Insurance Scheme designed specifically for our tenants and leaseholders.

More information

Property Insurance for Tenant s Liability & Optional Contents Cover

Property Insurance for Tenant s Liability & Optional Contents Cover POLICY SUMMARY Please read carefully and retain Property Insurance for Tenant s Liability & Optional Contents Cover (This is a portable insurance policy) Property Insurance for Tenant s Liability & Optional

More information

SUMMARY OF INSURANCE COVER GLASGOW WEST HOUSING ASSOCIATION LTD GLASGOW WEST ENTERPRISES LTD PREPARED BY BRUCE STEVENSON INSURANCE BROKERS LTD 38-40

SUMMARY OF INSURANCE COVER GLASGOW WEST HOUSING ASSOCIATION LTD GLASGOW WEST ENTERPRISES LTD PREPARED BY BRUCE STEVENSON INSURANCE BROKERS LTD 38-40 SUMMARY OF INSURANCE COVER GLASGOW WEST HOUSING ASSOCIATION LTD GLASGOW WEST ENTERPRISES LTD PREPARED BY BRUCE STEVENSON INSURANCE BROKERS LTD 3840 NEW CITY ROAD GLASGOW G4 9JT 0141 354 2883 CE SUMMARY

More information

Holiday Home Insurance

Holiday Home Insurance Holiday Home Insurance Our holiday home insurance policy is designed to provide you with a wide range of standard cover when insuring the buildings and contents of your holiday home in the United Kingdom.

More information

www.butterfieldgroup.com

www.butterfieldgroup.com Home Insurance P.O. Box 705 Grand Cayman KY1-1107, Cayman Islands www.butterfieldgroup.com Heritage HomeCover Proposal CUSTOMER INFORMATION Please answer all questions fully Please note that you must

More information

QBE HOME Cover HOME PROTECTION INSURANCE

QBE HOME Cover HOME PROTECTION INSURANCE QBE HOME Cover HOME PROTECTION INSURANCE for Home Basic for Building for Contents for Home Plus for Building for Contents for Valuables for Domestic Workers' Compensation for Personal Liability Please

More information

Simple. Application Form. Household Contents Insurance

Simple. Application Form. Household Contents Insurance Simple Household Contents Insurance Household Contents Insurance Application Form Please return your application form to: RSA, Direct Group Property Services, 4 Sidings Court, Doncaster DN4 5NU SOUTH LAKES

More information

AXA Exclusive. Information leaflet Home Buildings and Contents Insurance

AXA Exclusive. Information leaflet Home Buildings and Contents Insurance AXA Exclusive Information leaflet Home Buildings and Contents Insurance February 2014 Contents Why choose AXA Exclusive 3 Features and benefits 3 Important information 7 How much cover do I need? 7 Limits

More information

Overseas 606 Home Insurance Policy wording

Overseas 606 Home Insurance Policy wording Overseas 606 Home Insurance Overseas home claims in the first instance you should refer to your broker or insurance agent, otherwise contact our overseas claims team on: +44 (0)1206 773 776 Or by email

More information