Make a Claim

To enable us to deal with your claim promptly, please ensure you answer all the relevant questions.

You Should:

  • Undertake any temporary emergency repairs necessary to secure the property and prevent any further damage.
  • Retain all damaged items in case we need to inspect them.
  1. 1. Your details
  2. Policyholder Tenant Other
  3. 2. Circumstances of loss or damage
  4. 3. Claim notification (loss, theft or malicious damage claims only)
  5. Yes No
  6. Yes No
  7. 4. Claim details (please submit all documents that support your claim with this form)

  8. Building Claim
    • - 2 written estimates for the work required to repair the damage
    • - Any receipt/invoice for emergency repair(s)
    Contents or valuables claim
    • - 2 written estimates for necessary repair(s) or replacement(s)
    • - Proof of ownership of the item(s) - e.g. receipts, invoices etc
    Full description of item(s) - including make & model no. etc Purchase date Purchased from Original purchase price Method of payment Cost to repair or replace Amount claimed
  9. 5. Claim settlement
  10. Yes No
  11. Yes No
  12. Yes No
  13. If you would prefer payment direct to your bank, please provide the following information:

  14. 6. Additional information
  15. Please enable JavaScript to upload files.

    Uploaded Files

  16. 7. Data Protection Act 1998
  17. Any information you have provided will be dealt with by us in compliance with the provisions of the Data Protection Act 1998. For the purpose of providing this insurance & handling of any claims, which may arise under it, Underwriters may need to transfer certain information, which you have provided to other parties. By signing this proposal you agree that such transfer(s) may be made.

  18. 8. Declaration
  19. I hereby declare that all details given by me on this form are true and complete to the best of my knowledge.

  20. User Authentication
  21. Some people use robots (automatic programs) that have a negative impact on our website and its users. By answering the question below, you will prove you are not a robot.

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