HOME INSURANCE QUOTE
Please complete the form below for a full quote for insuring your Spanish property
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| TITLE |
| FORENAMES |
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| SURNAME |
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| TRADING TITLE (IF APPLICABLE) |
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| COUNTRY |
SPAIN |
| CORRESPONDENCE ADDRESS DETAILS |
| POSTCODE |
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| HOUSE NAME/NO. |
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| ADDRESS |
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| TOWN/CITY |
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| COUNTY/PROVINCE |
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| DAYTIME TELEPHONE |
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| EVENING TELEPHONE |
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| E-MAIL ADDRESS |
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| DETAILS OF PROPERTY TO BE INSURED, IF DIFFERENT FROM THOSE ABOVE |
| POSTCODE |
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| ADDRESS |
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| HOUSE NAME/NO. |
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| TOWN/CITY |
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| COUNTY/PROVINCE |
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| NIE/NIF/PASSPORT NUMBER |
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| DATE OF BIRTH (dd/mm/yyyy) |
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| PLEASE STATE YOUR OCCUPATION |
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NUMBER OF LOSSES OR CLAIMS IN THE PAST FIVE YEARS FOR YOU
OR ANY OTHER PERSON WHOSE PROPERTY IS TO BE INSURED
WHETHER YOU WERE INSURED OR NOT |
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| NUMBER OF YEARS WITHOUT A CLAIM |
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| COVER DETAILS |
| PLEASE STATE THE COUNTRY OF THE PROPERTY TO BE INSURED |
SPAIN |
| DO YOU OWN THIS PROPERTY? |
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| DO YOU REQUIRE BUILDINGS COVER FOR THIS PROPERTY? |
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| DO YOU REQUIRE CONTENTS COVER FOR THIS PROPERTY? |
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| IN WHAT YEAR WAS THE PROPERTY BUILT? |
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| DO YOU REQUIRE SUBSIDENCE COVER? |
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| WHAT IS THE BUILT AREA OF THE PROPERTY?(M2) |
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| IS THE PROPERTY YOUR PRIMARY RESIDENCE? |
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| PLEASE STATE THE TYPE OF YOUR PROPERTY |
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| PROPERTY DETAILS |
| IS THE PROPERTY BUILT OF SOLID NON-COMBUSTIBLE MATERIALS? |
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IS THE PROPERTY MORE THAN 300M FROM RIVER/SEA
OR IN AN AREA WHICH IS FREE FROM FLOODING? |
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| IS THE DWELLING IN A GOOD STATE OF REPAIR? |
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HAVE YOU OR ANYONE RESIDING WITH YOU BEEN REFUSED
INSURANCE OR HAD ANY SPECIAL TERMS/RESTRICTIONS
IMPOSED AT THIS OR ANY PREVIOUS HOME? |
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HAVE YOU OR ANYONE RESIDING WITH YOU BEEN MADE BANKRUPT
OR HAVE A BANKRUPTCY HEARING PENDING? |
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ARE THERE ANY SIGNS OR INDICATIONS OF POSSIBLE SUBSIDENCE
HEAVE OR LANDSLIP IN THE PROPERTY? |
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IS THE DWELLING SELF CONTAINED WITH SEPERATE LOCKABLE
ENTRANCE UNDER YOUR SOLE CONTROL? |
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HOW LONG WILL THE PROPERTY BE UNATTENDED WITHIN ANY
TWELVE MONTH PERIOD?(EXCLUDING NORMAL WORKING HOURS) |
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| IS THE PROPERTY TO BE INSURED A LEGALLY TITLED PRIVATE RESIDENCE? |
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| BUILDING DETAILS |
| BUILDING SUM INSURED (e.g 250000) |
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| CONTENTS DETAILS |
| PLEASE STATE HOW MANY BEDROOMS |
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PLEASE STATE THE AMOUNT OF COVER YOU REQUIRE FOR YOUR
HOME CONTENTS (general contents excluding valuables) |
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PLEASE STATE THE VALUE OF ANY UNSPECIFIED VALUABLES/ANTIQUES/PAINTINGS
(valuables mean gold/silver or other precious metals, jewellery, watches, clocks,
high value entertainment equipment and furs) |
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ARE THERE ANY VALUABLES WITH A SINGLE ARTICLE LIMIT IN EXCESS
OF 2000 EUROS OR 5% OF THE CONTENTS SUM INSURED?
THESE ITEMS MUST BE SPECIFIED. |
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| DO YOU REQUIRE ACCIDENTAL DAMAGE COVER FOR CONTENTS? |
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| ALARM DETAILS |
IS THE PROPERTY FITTED WITH AN INTRUDER ALARM THAT IS IN
WORKING ORDER? |
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| WHAT TYPE OF SIGNALLING DOES THE ALARM HAVE? |
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| IS THE ALARM MAINTAINED UNDER AN ANNUAL MAINTENANCE CONTRACT? |
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| IF YES PLEASE GIVE THE NAME OF THE ALARM COMPANY. |
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| SAFE DETAILS |
| DOES THE PROPERTY HAVE A SAFE INSTALLED? |
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| MAKE |
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| MODEL |
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| TYPE |
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n.b. The maximum amount of valuables covered when NOT contained in a safe is 3000 EUROS with a maximum single article limit of 400 EUROS.
Theft cover is excluded if the safe weighs less than 100kgs, or is not anchored to or embedded in the wall or floor. |
| SECURITY |
| DO YOUR DOORS HAVE AT LEAST THE FOLLOWING: |
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MULTI LEVER DEAD LOCK OR
SECURITY DEAD LOCK OR
FIVE LEVER MORTICE DEAD LOCK |
| DO YOUR WINDOWS PATIO & TERRACE DOORS HAVE AT LEAST THE FOLLOWING: |
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KEY OPERATED LOCKS WITH DOULE GLAZING/SECURITY GLASS/LAMINATED GLASS OR
KOMMERLING TYPE LEVER LOCKS WITH DOUBLE GLAZING/SECURITY GLASS/LAMINATED GLASS, OR
LOCKABLE CONCERTINA GRILLS, OR
ROLL DOWN /ELECTRIC SHUTTERS BUILT INTO STRUCTURE WITH INTERNAL BOLTS ON EACH SIDE, OR
WINDOW/PATIO DOORS/ BALCONY DOORS EXCEEDING 3 METRES FROM GROUND LEVEL ARE NOT ACCESSIBLE BY ANY OTHER MEANS.
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| ALL RISKS SECTION 3 |
SUM INSURED FOR UNSPECIFIED CLOTHING AND PERSONAL EFFECTS
(max 5000 EUROS with single article limit of 10% of unspecified sum insured) |
€ |
ARE THERE ANY ITEMS THAT YOU WISH TO SPECIFY UNDER
THIS SECTION |
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| AREA OF COVER FOR ALL ITEMS COVERED WITH THIS SECTION |
EUROPE |
| MONEY & CREDIT CARDS |
PLEASE STATE THE SUM INSURED YOU REQUIRE FOR MONEY
AND CREDIT CARDS - MAXIMUM 750 EUROS |
€ |
| PEDAL CYCLES |
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| GOLF EQUIPMENT |
| DO YOU WANT COVER FOR GOLF EQUIPMENT? |
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| PLEASE ENTER A DESCRIPTION OF YOUR GOLF EQUIPMENT |
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| PLEASE ENTER THE SUM INSURED FOR THE GOLF EQUIPMENT |
€ |
| DO YOU WANT COVER FOR A GOLF BUGGY? |
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NB The golf buggy is only covered by this policy while in use on a golf course by the policy holder, policy holders spouse or any authorised user over the age of 18.
Use of a golf buggy on public or private grounds other than a golf course is excluded.
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| PLEASE ENTER A DESCRIPTION OF YOUR GOLF BUGGY |
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| PLEASE ENTER THE SUM INSURED FOR THE GOLF BUGGY |
€ |
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