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Contact Information

Full name or company name

Date of birth

Phone number

Email address

Correspondence address

Property Information

Property address to be insured

Cover start date

Year built

Property type

Listed building?

Yes No

Number of flats

Number of storeys

Rebuild cost (£)

Construction Details

Wall type

Roof type

Floor type

Heating type

Basement or lower ground floor?

Yes No

Additional construction notes

Any flat roof areas?

Yes No

Cover Requirements

Occupant type

Property owners liability limit

Contents cover required?

Yes No

Contents cover value (£)

Loss of rent indemnity period

Only covers loss due to insured perils, not non-payment

Terrorism cover required?

Yes No

May be required by mortgage lenders

Directors & Officers liability?

Yes No

Claims & History

Any claims in the past 5 years?

Any history of subsidence or flooding?

Current insurer

Target premium (£)