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Property    

Disclaimer & Assumptions, if you do not fulfill these, don’t worry call us or mention this in the additional information box and we shall find an insurance cover appropriate for you.

  • Your home is built of standard construction (i.e. brick, stone or concrete walls, and a tiled, slate, concrete or asphalt roof), and has no building work in progress.
  • Your home has not suffered from flooding in the last 10 years.
  • Your home has never shown any signs of subsidence, landslip or heave, nor has ever been monitored for such occurrence or condition. Furthermore, you are not aware that your home is in an area where there has ever been evidence of subsidence, heave or landslip.
  • Your home is not left unoccupied for more than 15 consecutive days.
  • Your home is in a good state of repair and will always be maintained as such.
  • You or any person living in the home have never had insurance refused or had terms imposed. You or any person living in the home have never been convicted of any criminal convictions, and do not have any criminal prosecutions pending.
  • No safes kept at premises

IF YOU PREFER TO TALK TO US PLEASE CALL US ON 01234 353168 OR FILL UP AS MUCH AS YOU CAN & WE WILL CALL YOU BACK

Personal Detail

Full Name
Date of Birth
Occupation
Contact Telephone
Email Address
House Number & Postcode (e.g. 1, MK40 1AB)
Joint name policy (please complete box below)

Insurance details

Insuring What?

My Home
My Second or Holiday Home
Let Property (commercial)
Let Property (residential)

Type of Insurance?

Building and Contents
Building Only
Contents Only
Type Of Ownership
Other (Please Specify)
Mortgage Company Name (if applicable)
Type of Property
Other (Please Specify)
Number of Beedrooms
Number of Occupants (adult)
Number of Occupants < 18yrs
Type of Tenants (if applicable)
Building Sum Insured amount?
Contents sum insured?
Would you like accidental damage cover?

 Yes No

History

Number of Claim free years for: (Contents)
Number of Claim free years for: (Building)
How long lived at or let out this property?

Security

All External doors have secure locks? (Mortise, Dead Lock, Rim Locks)

 Yes No
French or Patio Doors?

 Yes No
Have Approved Locks as mentioned?

 Yes No
Windows Key operated Locks

 Yes No
Burglar Alarm

 Yes No
Smoke Alarm

 Yes No
Additional Information & Questions

 

Gill Insurance & Finance Consultants Ltd n 78-80 Tavistock Street n Bedford n MK40 2RP     Tel No. 01234 353168     Fax No. 01234 346304

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