Cover Details
What type of building is the property?
Is the above Property a commercial premises?
Yes No
If Yes, please enter the type of the commercial premises
Please state the full risk address, including postcode
Do you require buildings cover for this property?
Yes No
Do you require contents cover for this property?
Yes No
What year was the property built?
Is the property Grade listed?       
G1
G2
G3
Is the property your primary residence?
Yes No
Is the property owned outright or mortgaged if a bank/building society interest needs to be noted on the policy, please give details:
Is the property situated in a Holiday Park / Reservation area / Holiday site?
Yes No
Property Details
Is the dwelling in the sole permanent occupancy of yourself and relatives who normally reside with you?
Yes No
Is the property constructed with a flat roof, which cover more than 50% of the dwelling?
Yes No
If No, please give details in space provided
Have you or anyone residing with you been refused insurance or had any special terms/restrictions imposed at this or any previous home?
Yes No
If Yes, please give details in space provided
Have you or anyone residing with you been convicted of, or is any prosecution pending for, an offence other than a driving offence?
Yes No
If Yes, please give details in space provided
Have you or anyone residing with you been made bankrupt or have a bankruptcy hearing pending?
Yes No
If Yes, please give details in space provided
Is the dwelling built of brick, stone and thatched roofed or with slates, tiles, concrete or ashphalt?
Yes No
If No, please give details in space provided
Note - with Thatch, please complete the Thatch questionnaire at the end of this form
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Authorised and Regulated by the Financial Services Authority
Registered Office:
Lygon House, 50 London Road, Bromley, Kent. BR1 3RA