Landlord Insurance
 
  Get A Quote
 
 


What is Your Property Worth ?


    
About You...

Type of Landlord


Company Name


Title:
First Name:*
Last Name:*
Address:*




Postcode:*

Your Contact Details

Tel: (Main):*

Tel: (Other):


Email Address:*

Confirm Email:*
Any Claims History

Within the last 5 years have you or any of your partners or directors in connection with any business which you/they have been involved had any losses whether Insured or not or had any claims made against you, other than rent guarantee?
  


Previous No Claims Discount

1. Years claim free for buildings claims:

2. Years claim free for contents claims:

Have you or any of your partners or directors either personally or in connection with any business which you/they have been involved, or has any business with which you or any of your partners or director have been involved, ever:
3. Been convicted of or charged with (but not yet tried) a criminal offence other than a motoring offence or a spent conviction in accordance with the “Rehabilitation of Offences Act 1974”?

4. Been disqualified from being a company director?

5. Been declared bankrupt or are the subject of any bankruptcy proceeding, liquidation, administration, IVA, any voluntary or mandatory insolvency or winding up procedures?

6. Had any County Court judgement or a Sheriff Court decree?

7. Been prosecuted or have prosecution proceedings under the Health and Safety Work Act or any other statute or regulation?

8. Had any insurance proposal declined, renewal refused, a policy cancelled mid-term by underwriters, a policy declared void, a claim repudiated, or had any special or increased terms applied?

9. During the last 5 years have you been prosecuted or has any enforcement action, including any requirements for clean up or environmental restoration, been taken against you for contravention of any standard regulations or law relating to the release of any substance from any location into sewers, rivers, sea or onto land?

10. At the time of making this insurance application are you aware of any incident or circumstance that could reasonably be expected to have given rise to a claim, prosecution or enforcement action?



Address 1
[Click To Expand/Shrink]


Add Another Address

SUBMIT QUOTE
   Submitting Quote, Please Wait...
Error Submittig Quote. Please Try Again
Quote Submitted OK.
         You Will Received An Email From Us Shortly With Your Quote Attached.

6.6

Cover-4-Less is a trading name of Maintenance Direct Insurance Services Ltd
Authorised & Regulated By The Financial Conduct Authority Financial Services Registration Number: 707133
Registered In England No: 03152770. Registered office: Unit 3 Chapel Court, 126 Church Road, Hayes, UB3 2LW

This website uses cookies to ensure you get the best experience on our website.

Statement of Demands and Needs

Please complete all fields before reviewing this Demands & Needs Statement