Household Insurance Quote

Please complete the form below and send it to us (it will be transmitted by e-mail). We will contact you with your personal quotation based on what you tell us here. Fields marked with an asterisk (*) are required to be completed.

Title
First name*
Surname*
House name/number*
Street*
Town*
Postcode*
E-mail address*
Daytime contact number
Evening contact number
Date of birth
Occupation
Household Insurance  

Buildings sum insured £

Contents sum insured £
Accidental damage cover required? Yes No
Personal possessions away from home required? * Yes No
* If yes, please indicate maximum value
Your Property  
Is your property:  
House Bungalow Flat Other
Detached Semi-detached Terraced Other
Owner-occupied Rented Other
In what year was your property built?
Number of bedrooms
Is the home unoccipied for more than 30 days at a time? Yes No
Is the home unoccupied during normal working hours? Yes No
Is the house used for any business or professional purposes? Yes No
Is the house fitted with five-lever mortice deadlocks on all final exit doors? Yes No
Is the house fitted with key-operated window locks on all accessible windows? Yes No
Is the house fitted with an intruder alarm system? Yes No
Is there any history of subsidence or flood damage to your home or in the area? Yes No
Have you suffered any loss or damage or made any claims in the last five years? Yes No

If you have answered "Yes" to any of the above, please give details in the box below:

Current insurer:
When is your household insurance renewal due?

Are there are other material facts which may affect this quotation? Please give details in the box below.