Ryan Insurance 35 Years of Excellence

Ryan Insurance Group
Motor Insurance Quote

Please note that all material facts must be disclosed as failure to do so could invalidate your insurance cover. If you are in any doubt about any facts which might be material you should disclose them.
Generated with MOOJ Proforms
* Required Information.
Proposer Name: *

Proposer Details
Occupation: *

Date of Birth

Please Select the Day, Month & Year you were born
Day: *
Month: *
Year: *
E-mail: *
Marital Status: *
Correspondence Address: *
Daytime contact telephone numbers: *
What Directed You To Our Website?:

Policy Requirements
Do you require a Private Car or Commercial Vehicle insurance policy?

Vehicle Details
Make: *
Model in full: *
Year of make: *
Value: *
Purchase Date: *
Registration Number: *
Engine Size: *
Is Your Vehicle Automatic or Manual?: *
Fuel Type: *
Body Type: *
Number of seats: *
Number of Doors: *
Number of other vehicles in household: *
Postcode where kept overnight (if different from your address): *
Is the policyholder the registered owner? *
Yes
No
Is the policyholder the registered keeper? *
Yes
No
Is the vehicle modified? *
Yes
No
Is the vehicle imported and/or left hand drive? *
Yes
No
Does the vehicle have an alarm? *
Yes
No
Does the vehicle have an immobiliser? *
Yes
No
Is security Thatcham approved? *
Vehicle kept overnight: *
Personal mileage per annum: *
Business mileage per annum: *

Cover Requirements
Comprehensive: *
Third party, fire & theft *
Third party only *

Use of Vehicle
Social, domestic & pleasure purposes: *
Yes
No
Commuting for policyholder: *
Yes
No
Permanent Place of Work or Various Places of Work?: *
Business use for policyholder: *
Yes
No
Business use for policyholder inc. commercial travelling (selling): *
Yes
No
Business use or commuting for any other driver: *
Yes
No
Carriage of own goods (commercial vehicle policies only): *
Yes
No
Haulage (commercial vehicle policies only): *
Yes
No
Please supply further details where necessary:

Previous Insurance Details
Previous Insurer
Number of years no claims bonus:
Renewal date/cover required from
Protected no claims bonus required:

Drivers

Policyholder
Full Name: *
Date of Birth *
UK Resident: *
Yes
No
Sex: *
Male
Female
Marital Status: *
Full time occupation: *
Full time type of business: *
Part time occupation:
Part time type of business:
Licence type (e.g. Full UK): *
Length held:
Access to other vehicles:
Use of this vehicle (main driver, frequent, infrequent etc):

Driver 1
Full Name:
Date of Birth
UK Resident:
Yes
No
Sex:
Male
Female
Marital Status:
Full time occupation:
Full time type of business:
Part time occupation:
Part time type of business:
Licence type (e.g. Full UK):
Length held:
Relationship to policyholder:
Access to other vehicles:
Use of this vehicle (main driver, frequent, infrequent etc):

Driver 2
Full Name:
Date of Birth
UK Resident:
Yes
No
Sex:
Male
Female
Marital Status:
Full time occupation:
Full time type of business:
Part time occupation:
Part time type of business:
Licence type (e.g. Full UK):
Length held:
Relationship to policyholder:
Access to other vehicles:
Use of this vehicle (main driver, frequent, infrequent etc):

Driver 3
Full Name:
Date of Birth
UK Resident:
Yes
No
Sex:
Male
Female
Full time type of business:
Marital Status:
Full time occupation:
Part time occupation:
Part time type of business:
Licence type (e.g. Full UK):
Length held:
Relationship to policyholder:
Access to other vehicles:
Use of this vehicle (main driver, frequent, infrequent etc):

Convictions in the last 5 Years
Name of driver:
Date of conviction:
Conviction Code:
Fine:
Ban Length:

Convictions 2
Name of driver:
Date of conviction:
Conviction Code:
Fine:
Ban Length:

Accidents, Thefts, or Losses in the last 5 Years
Name of driver:
Date of Accident:
Full description of incident:
Own Costs:
Third party costs:
Personal injury:
No Claims Bonus affected:

Accidents, Thefts, or Losses in the last 5 Years (Second Incident)
Name of driver:
Date of Accident:
Full description of incident:
Own Costs:
Third party costs:
Personal injury:
No Claims Bonus affected:

Medical Conditions/Disabilities
Name of driver:
Description:
Are DVLA aware:
Is licence restricted:
Is vehicle adapted:
Are there any other requirements for this insurance policy?
Current Renewal Premium:
Current Preferred Excess:

Terms & Conditions

  • I understand Ryan Insurance Group use a select panel of insurers for this type of business
  • We must also make you aware that some of the insurance providers may carry out checks with credit reference and fraud protection agencies in order to provide you with a quote
  • My quotation will be valid until the end of the current month
  • I am obliged to provide all material facts that may affect the rating or acceptance of the policy, as failure to do so could invalidate my insurance cover
  • Ryan Insurance Group is obliged by law to give me the opportunity to hear how they give advice, deal with compensation and handle complaints. This information is contained within their terms of business agreement (attached).

Agreement
I have read and agree to the terms and conditions above: *

Hover over the left image and enter the security code into the right textfield.

Ryan Insurance Group Limited is authorised and regulated by the Financial Services Authority
Members of The Unitas Alliance the leading Alliance of Independent Insurance Brokers and the only group with complete UK coverage, offering National Representation backed by Local Service
Copyright © 2011 Ryan Insurance Group. All Rights Reserved. Website designed, hosted & maintained by DPS Technology Group | Privacy and Security | Site Map