Please ensure you have read the Policy Summary (on the left of this page) and have familiarised yourself with the level of cover available.

1

YOUR DETAILS

Title

First Name

Surname

Email

Telephone


Have you come through
a lettings agent?

Do you require anybody else to be named on this policy?

If yes, please state Title and Name:


If yes, which letting agents do you use?

2

PROPERTY DETAILS

Address

Town/City  

County  

Postcode      

Have you already moved into this property?

If no, enter the date you are moving into the property (dd/mm/yyyy)

3

ABOUT YOUR COVER

What level of cover do you require?

Do you require cover for a bicycle
(up to £500) ? tooltip

If yes, please provide the bicycle make, model and replacement value. In the event of a claim proof of ownership may be required:

Do you require cover for a laptop (including tablet devices), inside and outside the home? tooltip

If yes, please provide details of the laptop. Include make, model and replacement value. In the event of a claim proof of ownership may be required:

Do you require cover for a mobile phone inside and outside the home? tooltip

If yes, please provide details of the mobile phone(s). Include make, model and replacement value. In the event of a claim proof of ownership may be required:

Do you require cover for personal possessions (other than laptops, mobile phones and pedal cycles) outside the home? tooltip

If you selected cover for possessions kept outside the home, please provide details of any items worth over £250 for which you require cover outside the home. Please include makes, models and replacement values. Do not include laptops, mobile phones and pedal cycles. Proof of ownership may be required in the event of a claim: tooltip

Have you had any claims on any contents insurance policy in the last 5 years?

Please provide details below. You should include the date of the claim, the type of claim and the settlement amount:

I have read the
Demands and Needs Document
Tick to confirm that you have read this document

I have read the Terms and Conditions
Tick to confirm that you have read this document

I have read the Policy Summary
Tick to confirm that you have read this document

Please complete the sum:       
8 + 7 =


Please note: Make sure you have filled all fields correctly before obtaining your quote. Required fields will glow RED if your data is missing or if you have entered invalid details.