| Title |
|
Forename |
|
| Surname |
A value is required.Minimum number of characters not met. |
Marital Status |
|
| Date of Birth |
|
E-mail address |
A value is required.Invalid format. |
| Contact Phone |
A value is required.Invalid format. |
Mobile Phone |
|
| Address |
|
Town |
|
| County |
|
Post Code |
|
| Best quote so far? £ |
|
Renewal/Start Date Required |
|
| Have you ever been refused insurance, had a policy cancelled or any special terms imposed? |
Please select a valid item. |
| Have you any CCJ's, bankruptcy orders, previous insolvent companies or criminal convictions? |
Please select a valid item. |
| What is your occupation? |
|
| Caravan make |
|
Caravan model |
|
| Year made |
|
Purchase date |
|
| Length |
A value is required.Invalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.
Metres or feet? |
Width |
A value is required.Invalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.
Metres or feet? |
| Serial number |
|
Wheelclamp? |
Please select a valid item. |
| Hitchlock? |
Please select a valid item. |
Leglocks? |
Please select a valid item. |
| Other Security? |
Please select a valid item. |
Twin axles? |
Please select a valid item. |
| Type of site |
Please select a valid item. |
Site security |
Please select a valid item. |
| Does the site have locked gates OR manned barriers OR swipe card access? |
Please select a valid item. |
| CCTV on site? |
Please select a valid item. |
How many caravans on site? (approx.) |
|
| |
If you require new for old cover please fill in the green box (right), otherwise use the blue box |
| Current caravan value £ |
|
New replacement value £ |
|
| Equipment value: this includes generators, gas bottles, toilet tents, batteries, wheelclamps, steps etc. £. |
|
| Contents: this includes clothing, luggage, household goods, TV's etc. whilst in the caravan £. |
|
| Awning cover |
|
Age of awning |
years |
Any previous losses or claims? Please give details of claim type (e.g. fire, flood, theft etc.), claim date, claim amount and whether the claim has been settled or not. |
|
| Caravan type |
Please select a valid item. |
Is it permanently sited? |
Please select a valid item. |
| Is it permanently occupied? |
Please select a valid item. |
Have there been any nearby claims? |
Please select a valid item. |
| Is the caravan hired out? |
Please select a valid item. |
Is it used for business use? |
Please select a valid item. |
| |
How many years no claims do you have? |
years |
|