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Home > Personal Insurance > Listed Property Insurance Quotation Request

Listed Property Insurance Quotation Request - Page 1 of 1

Personal Information

* = Required

Proposer Name *

DOB *

Occupation

Telephone *

Email *

Correspondence Address *

Postcode *

Address to be Insured (if different)

Postcode

Property Details

* = Required

Type of Property *

Year Built *

Number of Bedrooms *

Is the property your main residence? *

Yes
No

Is the property standard construction (brick walls and pitched tiled roof)? *

Yes
No

Is the property normally occupied on a daily basis? *

Yes
No

Will the property be unoccupied for more than 30 days consecutive days? *

Yes
No

What grade is your listed property? *

Is there any renovation/construction work in progress or planned for next year? *

Yes
No

Is there any signs/history of subsidence, heave or landslip? *

Yes
No

Is there any history of flood or is the property situated within ¼ mile of watercourse or sea? *

Yes
No

Are there any trees within influencing distance? *

Yes
No

Is the property used in connection with trade or business? *

Yes
No

Is the property occupied by any non-family members? *

Yes
No

Have you ever had any previous terms imposed by insurers or had renewal refused? *

Yes
No

Has any resident received a criminal conviction or have a prosecution pending? *

Yes
No

Has any resident received any county court judgments or declared themselves bankrupt? *

Yes
No

Please supply any further details:

Locks

* = Required

Are all external doors secured by 5 lever mortice deadlocks? *

Yes
No

Are any patio doors secured with top and bottom locks? *

Yes
No

Are all accessible windows and skylights secured by key operated window locks? *

Yes
No

Alarms

* = Required

Burglar alarm – Bells/Siren Only *

Yes
No

Burglar alarm – Connected to a central monitoring station *

Yes
No

Fire Alarm *

Yes
No

Smoke detectors *

Yes
No

Safe	* = Required

Do you have a safe installed? *

Yes
No

If yes, please confirm the make and model

Is the safe fitted to the wall, anchored to the floor or free standing?

Please confirm the cash rating of the safe

Is there any other security information to be taken into account e.g. neighbourhood watch?

Previous Insurance & Claims History

* = Required

Renewal date / Cover required from *

Current / Previous Insurer

Renewal premium

Please confirm how long you have held contents insurance for?

Please confirm how long you have held buildings insurance for?

Please confirm details (date/claim info/amount) of any claims you have made under any Buildings or Contents insurance policy in the past 5 years:

Cover

* = Required

Please confirm the sums to be insured by completing the table below. If you require any assistance completing this table or are interested in having a professional valuation or a risk management survey, please contact us to discuss further.

A number of our insurers will automatically include full accidental damage and provide cover for all of your contents on a worldwide basis. If this is not required please indicate below.

The buildings sum insured should represent the full re-building cost of your home – for further information visit abi.bcis.co.uk

Buildings

* = Required

Buildings sum insured (to represent the full re-building cost of your home – for further information visit abi.bcis.co.uk)

Outbuildings sum insured

Contents

* = Required

General contents

Is accidental damage and worldwide cover required?

Yes
No

Wine collection

Outdoor items (e.g. garden furniture, statuary or urns)

Ride on mowers, tractors or quad bikes

Fine Arts & Antiques

* = Required

Household gold, platinum, silverware, porcelain and glass

Paintings, drawings, maps, prints, photographs, books, manuscripts, tapestries and rugs

Antique and/or designer furniture

Clocks, barometers, curious, statues, sculptures, stamps, coins, medals, musical instruments, antique guns and other collections

Valuable/Personal Possessions/Specified Items

* = Required

Personal possessions (total value of items regularly removed from the home e.g. pedal cycles, cameras, mobile phones etc)

Jewellery and watches normally worn

Jewellery and watches kept in a safe

Jewellery and watches kept in bank vault or safety deposit

Saddles and tack

Guns

Money

Credit Cards

Please list any single item to be insured which exceeds £5,000 in value

Please list any pedal cycle to be insured which exceeds £1,000 in value

Are there any other specific requirements for the insurance policy?

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