Sum Insured Details
Buildings sum insured *
Contents sum insured
Total amount of loss of rent required
Construction
Are any sandwich/composite panels used in the construction of any part of the building?
No
Yes
Are they LPC approved?
No
Yes
What is the construction of the walls of the building? *
Please select
Brick
Cob
Concrete
Corrugated Iron
Essex
Fibreglass
Flint
Glass
Material not listed
Metal
Plasterboard/Pre Fab
Plastic
Prefabricated
Sandstone
Stone
Stramit
Timber and Plaster
Timber Cladding
Timber Frame (post 1980)
Timber Frame (pre 1980)
Wattle and Daub
Woodwall
Construction of internal floors *
Please select
Concrete
Wood
What is the construction of the roof of the building? *
Please select
Asbestos
Bitumen / Asphalt
Concrete
Corrugated Iron
Felt on Timber
Fibreglass
Glass
Material not listed
Metal
Plastic
Shingle
Slate / Tile
Timber
Woodwork
Are there any roof sections that have a separate construction than the one noted? *
No
Yes
What is the overall percentage of this section of roof?
Please select
0%
1-10%
10-25%
25-50%
50-75%
75-100%
Please specify
How many floors are located at the premises?
1
2
3
4
5
6
7
Security Details
Please state the type of intruder alarm protecting the premises *
Please select
Bells only
Digital Communicator
None
Private Dialer
Redcare Dualcom Plus
Redcare Dualcom
Redcare GSM
Redcare
Do the premises have an automatic fire alarm conforming to LPC rules?
No
Yes
What is the security on all final exit doors? *
Please select
A mortice Lock
Boarded
Chubb locks
Mortice Dead Locks
Padlocks
Shutter and grilled
Steel emergency exit doors
UPVC
Yale
What is the security on all ground floor and accessible windows? *
Please select
Boarded
Key operated
Latches or catches
No windows at premises
Screwed Shut
Shuttered and Grilled
UPVC
Do the premises have roller shutters and or grills on all accessible windows?
No
Yes
How often do you/your representative attend the address to be insured in order to carry out maintenance and/or regular inspections?
Please select
Daily
Every 7 days
Every 14 days
Monthly
Quarterly
6 monthly
Annually
Do the premises benefit from a cctv system?
No
Yes
Please select the type of cctv system protecting the premises
Please select
Continuously recorded
Monitored by a cerntal station
Monitored by a secuirty guard
Claim History
Have the premises suffered any loss or damage whether insured or not in the last 5 years?
No
Yes
How many claims have the premises suffered in the last 5 years?
Type of Loss Date of Loss Amount of Loss Claim Status Claim Details
Type of Loss
Please select
Accidental damage
Collision
Earthquake
Escape of Oil
Escape of water
Explosion
Fire
Flood
Ingress of water
Liability
Lightning
Malicious damage
Other
Storm
Subsidence
Theft
Weight of snow
Date of Loss
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Amount of Loss
Claim Status
Please select
Not pursued
Outstanding
Rejected
Settled
Withdrawn
Claim Details
Add
Have you made any insurance claim on any other insurance policy for property you have owned within the last 5 years?
No
Yes
Additional information
Have you or any of your partners or directors in connection with any business which you / they have been involved in had any losses whether insured or not or had any claims made against you?
No
Yes
Type of Loss Date of Loss Amount of Loss Claim Status Claim Details
Type of Loss
Please select
Accidental damage
Collision
Earthquake
Escape of Oil
Escape of water
Explosion
Fire
Flood
Ingress of water
Liability
Lightning
Malicious damage
Other
Storm
Subsidence
Theft
Weight of snow
Date of Loss
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Amount of Loss
Claim Status
Please select
Not pursued
Outstanding
Rejected
Settled
Withdrawn
Claim Details
Add
