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PROPERTY OWNERS APPLICATION

This form is designed to capture the information on which the contract of insurance will be based. All information you provide must be true and correct to the best of your knowledge and belief. Any information that is likely to influence insurers in the assessment or acceptance of your application, such as intended unoccupancy of your home, must be disclosed. If you are in any doubt as to whether a fact is relevant you must disclose it. Please note: you may skip sections of the form but the overall process will be smoother the more information you can give us.

1. Proposer details

2. Property details

3. Construction details of the risk address

4. Details of cover required

5. Security

6. If the property is unoccupied

7. Claims information

7. Claims information (2)

7. Claims information (3)

8. Compliance & Insurance disclosure

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Floors

Roof

Wall / Frame

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What security is there on site?

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Please provide details of any claims or losses which have affected the property during the last 5 years

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  • PROPOSER DETAILS
  • PROPERTY DETAILS
  • CONSTRUCTION DETAILS OF THE RISK ADDRESS
  • DETAILS OF COVER REQUIRED
  • SECURITY
  • IF THE PROPERTY IS UNOCCUPIED
  • CLAIMS INFORMATION
  • INSURANCE DISCLOSURE

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London Office

57-60 Charlotte Road, London, EC2A 3QT

T: 0207 199 3258

F: 020 8812 3930

info@insurancetailors.co.uk

www.insurancetailors.co.uk


Business Hours

Weekday: 8.30am to 5.30pm

Saturday: closed

Sunday: closed

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