About You
Details of the person taking out the insurance
Title
Mx
Mr
Mrs
Miss
Ms
Dr
Rev
Name
Date of Birth
Are you a full-time student?
Yes
No
Email
Telephone Number
Would you like to add a second applicant?
Yes
No
Title
Mx
Mr
Mrs
Miss
Ms
Dr
Rev
Name
Date of Birth
Are you a full-time student?
Yes
No
Email
Telephone Number
Eligibility
I/We confirm all of the following are true:-
Neither I, or anyone to be insured under this policy, have any unspent convictions or prosecutions pending (other than motor convictions);
Neither I, or anyone to be insured under this policy, have had insurance cancelled, declined, declared void or had any special terms imposed as a result of non-disclosure of information, fraudulent activity or misrepresentation, whether intentional or not;
The property will not be left unoccupied for more than 60 days in a row;
The property will not be used for business or professional purposes, other than clerical work.
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Property details