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Home Insurance – Assessment of Demands and Needs

  • Other Insurance Brokers, Insurance Companies or Insurance Intermediaries that you have approached for quotations to date
  • Policy Holder Details

  • Name ID Number Date of Birth Actions
    There are no Policy Holders.
  • Details and amounts of any previous losses and/or claims
    Accident Details Actions
    There are no Losses.
  • Name of the current insurance company the property is insured with, if applicable
  • Have you ever been refused insurance?
  • Do you have any previous convictions?
  • Property to Insure

  • Address of the property to be insured
  • Address of any garage to be insured
  • Is the property occupied solely as a private residence?
  • If the property your permanent residence or a holiday home?
  • This amount should be enough to rebuild your home as new, including the value of all the fixtures and your proportionate share of any common parts and passenger lift.
    Please enter a number greater than or equal to 0.
  • This amount should represent the full replacement value as new of all your home contents.
    Please enter a number greater than or equal to 0.
  • Please enter a number greater than or equal to 0.
  • Current replacement value of items/valuables to be insured
    Item/Valuable Description Item/Valuable Current Replacement Value Actions
    There are no Items.
  • List and provide details of any Special individual Items / Valuables you may wish to insure inside the Home
    Item/Valuable Description Item/Valuable Current Replacement Value Actions
    There are no Items.
  • Additional Details

  • Do you already own the property or are you in the process or purchasing it?
  • Do you carry out any work from your home, or see to clients in part of the property? Give details.
  • Details of any other insurance policies that you may consider transferring and placing through us
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