Home Insurance Quotation

Your Details
Title:*
First name:*
Surname:*
Email address: *
Contact number: *
Mobilenumber (if different):
Address:*
Postcode: *
Date of birth:*
Occupation:*
Your Property
Who occupies the property?* Owner occupied - mortgaged
Owner occupied - not
mortgaged
Professional (working)
tenants
Student or DSS
Other
Address of property to be insured:
(if differs from correspondence address)
Type of property: *
Year built:*
Number of bedrooms:*
Total number of rooms:*
Is the property listed? If so state the grade listing:*
What percentage of the roof is flat:*
Please descirbe the construction of walls :*
Please describe the construction of the roof:*
Security
Are you a Neighbourhood Watch
member at the insured property?*
Yes No
Please describe the types of locks
the property has on all final exit
doors and accessable windows
(e.g. 5 lever mortice deadlocks, key operated mortice bolts etc):*
Is there a NACOSS approved alarm installed at the property?*
Yes No

Is there a smoke alarm in operation
at the property?*
Yes No
Building and Contents Sum Insured
Buildings sum insured (if required):
Accidental damage cover required for buildings: Yes
Contents sum insured (if required):
Accidental damage cover required for contents:

Yes

Is any cover required for valuables and personal effects away from the home?*
Yes No
Specified personal effects sum insured (min 1,000 any one item):
Unspecified personal effects sum insured (max 1,000 any one item):
Pedal cycles sum insured:
Please provide full details of any claims made and/or losses suffered, under a home insurance policy (whether or not a claim was made), during the past5 years:* (if none please state so)
Number of years of no claims discount:
Your Enquiry
Enquirytype:*
Policy number (if applicable):
Previous / current insurer:*
Date cover required / renewal date:
Details of your enquiry:
Please note: cover is not in force until confirmed by us.
Contacting You
Preferred contact method:
Preferred contact time (Monday-Friday):
How did you hear about us:
TowergateRisk SolutionsBournemouthis a trading name of Towergate Underwriting Group Ltd. Wewould like to contact you from time to time about products and services (or with news, offers, services and promotions) that we feel may be of interest to you. By providing us with your contact details, you consent to being contacted by these methods for these purposes.

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Please tick the box if you prefer not to receive marketing communications from us by email, text messaging or other electronic means.