Non-Standard Household Enquiry
First Name * Your First Name
Last Name * Your Last Name
Email Address *
Renewal Date * Policy Start or Renewal Date
Property Address Address of Property you wish to insure
Post Code * Postal Code
Occupation Occupation? (Manager / Co. Director inadequate)
Date of Birth? * Your Date of Birth
Is the Property used for any business, trade or professional purposes? If unsure, please comment below in 'Comments'
Owner Occupied
Weekend / Holiday Home?
Is the Property Rented?
Let? Is the property let?
If Let, please specify If the property is let, please specify the type of tenant let to.
If part owner occupied/part let? specify FULL details
If Shared Occupancy? specify FULL details, including occupations.
Is the property currently unoccupied for more than 60 days in a total year?
If Weekend / Holiday Home, please details occupancy pattern
Private Dwelling?
Purpose Built Flats?
Converted Flats?
No. of Flats / Units?
Smoke Alarms Fitted? *
Does anyone living at property regularly smoke? *
Construction of Walls?
Construction of Roof?
What percentage of roof is flat?
If Timber Constructon; is there any wood-burning stoves or open fires?
If Timber Construction; When was the last electrical inspection?
Age of Building
Property Listed?
Listing?
Is the property in a good state of repair?
Is the property undergoing extensive renovation or conversion?
Number of Bedrooms
Buildings Sum Insured?
Buildings: Standard or Accidental Damage?
Contents: Sum Insured?
Contents: Standard or Accidental Damage?
Unspecified Personal Effects Sum Insured?
Bikes
Specified Items
List Specified Items over £1,000
Is the property fitted with mortice dead locks on the final exit doors? *
Key operated Window Locks on all accessible wndows? *
Neighbourhood Watch member? *
NACOSS Aproved Alarm fitted? *
Alarm: Bells only or Central Station? *
How long held household insurance? * No. years
Have there been any losses or claims in the last five years? *
If YES, please give brief details:
Has the property / area a history of storm, flood, subsidence, landslip or heave?
Are there trees within a potential influencing distance of the property? (Over 3M tall and within 3M of property)
If YES; distance from property, height, type and spread of tree?
Previous Convictions? *
Ever been refused cover or had additional terms applied? *
Existing Insurer? * Mark 'none' if uninsured
Target Premium? *
Years on No Claims Discount? *
Policy Excess: Buildings
Policy Excess: Contents










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