Quotation Request

xxxx InsureMyRental

Client Details

Premises Specific Cover

Policy Specific Details

Claims

Statement of Fact

Legal Protection

Cover Details

Notes

Documents Only

Client Details

Proposer/Company Name

Trading Name(s)

Contact Name

Account set up details (these will be used later to retrieve saved quotations or policy documents)

Email you will log in with this

Forgot your password?

Email enter again

Password

Password enter again

Please provide a target premium if you have one

If you have been given a Voucher Code please enter it here.

How to obtain your voucher code: Please contact your nearest participating letting agent to obtain your voucher code. This will enable you to purchase any of our products at a discounted rate.

What is the renewal or expected start date of this policy

The cover commencement date is the date from which your cover will start and has been pre-set at today's date. Please amend this date if you require the cover to commence after today. Please note the date entered cannot be more than 30 days from today's date.

Do you wish to charge an additional policy fee (This will be added to the quote/schedule)

Correspondence Address

UDPRN

Organisation

Line 1

Line 2

Town/City

County

Postcode

Premises Specific Information

Fire Code

Theft Code

Postcode Area

Flat Roof Load

Fire Rate

MPlant Rate

Address of the premises to be insured.

UDPRN

Organisation

Line 1

Line 2

Town/City

County

Postcode

PostcodeNoSpace

Postcode IPT Check

GY, JE and IM postcodes remove IPT

Occupancy Details

Select the occupancy of the premises (select more than 1 if required):

Professional let example : working people / or working people on benefits

Click on the + or - to add or remove trades

Occupancy

How many tenants/family units occupy the property?

Sums Insured Details

Buildings Sum Insured (Total cost to rebuild)

Landlords Contents

If you are letting the property to professional or retired tenants and require more than £5,000 of contents cover please enter the full value otherwise leave the contents sum insured blank. If the property is not let to professional or retired tenants please enter the full contents value.

Professional Let and Retired Let occupancies will automatically include £5,000 Landlord's Contents.

. Landlords Contents Included

. Landlords Contents Rated

ANNUAL Loss of Rent

If more than 20% of the building sum insured is required please enter the full value

20% of Building Sum Insured is automatically included

. Annual Loss of Rent Included

. Annual Loss of Rent Rated

Do you require cover for Accidental Damage?

Please note if your tenant is a professional / working or a retired tenant you can receive Accidental Damage on buildings FREE OF CHARGE. Please change the drop down box to Yes to receive this benefit. If you have a different type of tenant there will be an extra charge for this additional policy cover. An example of an Accidental Damage claim would be the tenant putting their foot through the roof whilst storing something in the loft.

Choosing “No” will reduce your premium but leave you at risk in the event of damage to your property

YesNo

Do you require cover for Subsidence, Heave and Landslip

YesNo

Subsidence, Ground Heave & Landslip Supplementary Questionnaire

Is the property free from and in an area which is free from any signs of subsidence, heave or landslip both now and in the past.

YesNo

Please provide details in the space below

Is the property in an area where there are any underground workings, active inactive or proposed, or built on made up or reclaimed land?

YesNo

Please provide details

Is the property nearby to any cliffs, hills, quarries or other excavations or similar features?

YesNo

Please provide details

Has the property been extended?

YesNo

Please give details including the year the property was extended

Are there any trees within 10 metres of the building?

YesNo

Please provide details in respect of the trees surrounding the property including height, distance from premises and species

The Premises

Type of Property

How many flats within the block?

How many bedsits within the property?

Please provide additional information about the property type

How many years have you owned the premises?

What is the estimated year of construction of the premises? (Depending on age, a discount may be available)

Are the Premises listed?

YesNo

Are the premises fully occupied and not vacant for more than 14 consecutive days at a time?"

YesNo

Please provide additional information in respect of the occupancy

Please provide information on the works being carried out including the project length.

Are the premises in an area which is free from flooding and at least 250 metres away from the nearest lake, river, canal or tidal waters?

YesNo

Please provide details in the space below

Are the premises, in a good state of repair?

YesNo

Please provide additional information in respect of the above

Please describe below

Is any part of the roof constructed of flat felt on timber?

YesNo

Security

Are all final exit doors fitted with 5 lever mortice deadlocks complying to BS3621?

YesNo

Please provide additional information in respect of the above

Are all accessible windows, fanlights and skylights fitted with key operated locks?

YesNo

Please provide additional information in respect of the above

Please state the type of alarm protecting the premises:

Alarm Details

Please give details of any other protections to the premises such as a safe, smoke detectors, neighbourhood watch etc

Interested Parties

Are there any Interest Parties to be noted against this premises?

The will enable you to note the mortgage company and there reference. Some mortgage companies insist there name being noted on the policy.

YesNo

Please provide details of one or more interested parties below

Click on the + or - to add or remove an Interested Party

Name	Address Line 1	Address Line 2	Town	County	Post Code	Ref

TradeExcess

Contents Premium

Previous Buildings Discretionary Discount

Policy Specific Details

Cover Required:

Employers Liability limit required.

Employers Liability Premium

What is the company's Employers Reference Number (ERN)? This may be referred to as the Employer's PAYE Reference.

UK businesses employing one or more people are required to have an ERN (Employer’s Reference Number, also commonly referred to to as the ‘Employer PAYE Reference’), which is a unique reference number for your employees’ income tax and national insurance contributions. You will find your ERN printed or written on mandatory documents including the P45, P60, P11/D and on most payslips. It looks something like this: NNN/Aznnnnn (maybe with up to 7 digits).

Property Owners Premium

Legal Expenses Premium

Claims

Have you or any of your Partners or Directors in connection with any business which you/ they have been involved had any losses whether insured or not or had any claims made against you?

YesNo

Please provide details of all claims below

Type of Loss	Date of Loss	Amount of Loss	Claim Status	Claim Details

Please provide any other material facts which may have a bearing on the underwriting of this risk

Statement of Fact

Have You or any of your Partners or Directors either personally or in connection with any business which you/they have been involved ever :-

and during the last five years, whether insured or not and excluding driving offences, been involved with :

If you have answered yes to any question above, please provide additional information

I confirm that ALL information provided is accurate and correct:

We now have all the information we need to calculate your landlords property insurance premium

Policy Cover

Our Standard Policy includes Cover for:

Legal Defence

Property & Squatter Protection

Helpline

Please Click here to see the Silver Policy Summary of Cover.

Policy Cover

Our Standard Policy includes Cover for:

Legal Defence

Property & Squatter Protection

Rent Recovery

Tenant Eviction

Helpline

Please Click here to see the Adverse Policy Summary of Cover.

Policy Cover

Our Gold Policy includes Cover for:

Legal Defence

Property & Squatter Protection

Helpline

Rent Recovery

Tenant Eviction

Tenant Property Damage

Rent Guarantee

Please Click here to see the Gold Policy Summary of Cover.

Cover Details

Claims 1yr Count

Claims 1yr Amount

Claims 3yr Count

Claims 3yr Amount

Claims 5yr Count

Claims 5yr Amount

Fire Claims 5yr Count

Fire Claims 5yr Amount

Storm or Flood Claims 5yr Count

Storm or Flood 5yr Amount

Theft Claims 5yr Count

Theft Claims 5yr Amount

Escape of Water Claims 5yr Count

Escape of Water Claims 5yr Amount

Valid Voucher Code (1 = Yes)

Additional Notes

Documents Only

Scheme Contact Email

Scheme Broker Address

Policy Prefix

Policy Type

0 = None
1 = Silver
2 = Gold
3 = Adverse

Policy Status (do not change)

1 = First Premium
2 = Adjustment
3 = Renewal
4 = Cancellation

InterHannover Wording

Silver Wording

Gold Wording

Adverse Wording

InterHannoverCert

MSL Cert

Legal Rights Discount Code

Oxygen Wording

Oxygen Cert

Index Linking Date

Index Linking - Contents

Index Linking - Buildings

InceptionDateForDocReferences

Set Discretionary Discoun	@	%	£0.00
Set Claims Discount	@	%	£0.00
Set Claims Load	@	%	£0.00
Set Voucher Code Discount	@	%	£0.00
Set Minimum Net Load	£		£0.00


Total Premium (Net)			£0.00

+ IPT	@	%	£0.00
+ Policy Fee	£		£0.00

Total Premium			£0.00

Total Commission			£0.00
(Due From Broker)			£0.00