Request a Quotation - Listed Property

REQUEST A QUOTE

"*" indicates required fields

1POLICY HOLDER DETAILS

2FURTHER DETAILS

3PROPERTY DETAILS

4COVER REQUIRED

5SEND REQUEST

Please ensure you provide accurate information on the form below and we will contact you as soon as possible with a quote (in some circumstances this could be immediately) or to confirm any further details we may need. If you have any questions please call us on 01795 844939.

POLICY HOLDER DETAILS

Policy Holder Name:

Title First Name Last Name

Email Address

Address to be insured (Incl. Postcode):*

Address City Postcode

Is this your postal address?*

Yes

Correspondence Address (Incl. Postcode):

Address City Postcode

Phone Number:*

Buildings Rebuild Value (Including Outbuildings) Please put £0 if unsure.*

In order to ensure that you have the correct cover, you need to specify an accurate rebuild sum for your property. This is different to the property’s market value and must reflect the full rebuild cost to reinstate the property as it was using appropriate materials and methods as instructed by your conservation officer. If you are unsure of the rebuild cost for your property, please speak to one of the team on 01795 844939 for assistance in arranging for a professionally qualified surveyor to advise on a suitable figure.

Do you require contents insurance?*

Yes

Contents Cover Required*

When do you need cover by?*

Is any part of the roof thatch?*

How did you hear about us?*

Further Details

Date of Birth:*

Occupation:*

Trade/Business (please also specify the industry you work in)*

Employer:

Current Insurer (important)

If you are purchasing the property or have recently exchanged or completed please type in 'New purchase'

Your renewal premium (important)

If you are purchasing the property or have recently exchanged or completed please type in 'New purchase'

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I am happy to be contacted with relevant information from LPOC via (please tick)

Post

Phone

Remember, to receive the free LPOC newsletter The Listed Property Insider, which includes helpful information on the issues facing listed property owners, please opt-in to receive emails.

Are you the owner of the property?*

Yes

Is it a Joint Policy?*

Yes

Joint Policy Holder Name:*

Title First Name Last Name

Date of Birth:*

Email Address*

Occupation:*

Trade/Business (please also specify the industry you work in)*

Employer:

Phone Number:*

ADDITIONAL INFORMATION

Have you had any claims in the last 6 years?*

Is the claim settled or still outstanding?*

Date of Claim*

Cause of Loss*

Please detail a description of the claim(s)

Cost of Claim*

in £

Please tell us any additional information about the claim(s)

Have there been any further claims in the last 6 years?*

Yes

Additional Claims

Is the additional claim settled or still outstanding?*

Date of additional claim*

Cause of Loss*

Please detail a description of the claim(s)

Cost of additional claim:*

in £

Please tell us any additional information about the claim(s)

Please list any further claims

Are you and everyone residing at the property a UK Resident?*

Have you or anyone living at the property ever been refused insurance, or had any special terms imposed?*

Have you or anyone living at the property ever had a County Court Judgement (CCJ) or IVA (individual voluntary arrangement) or Debt Arrangement Scheme (DAS) or unspent/unsatisfied bankruptcies? (if yes please give details)*

Details

Have you or anyone living at the property been charged with or convicted of any offence (other than motoring offences) received a police caution or have any pending prosecution that should be declared as per the Rehabilitation of Offences Act 1974?*

General information or outstanding matters:

We continually assess our product offerings and collaborate with our insurers to secure the most competitive premiums for our clients. We're also exploring potential discounts for customers who choose to insure multiple products with us. To better understand which products and services our customers might like us to offer in the future, please let us know your areas of interest below:

Equine Insurance

Classic Car Insurance

Pet Insurance (dog/cat)

Private Medical Insurance

Other

Please state

REQUEST A QUOTE

POLICY HOLDER DETAILS

Further Details

PROPERTY DETAILS

THATCHED PROPERTY DETAILS

HOW IS THE PROPERTY OCCUPIED?

SECURITY & FIRE PROTECTION INFORMATION

COVER REQUIRED

ADDITIONAL INFORMATION

Additional Claims

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