Specialist Home Insurance, Specialist Property Insurance | EmberJD

Specialist Home Insurance

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Please click on each tab below and carefully answer all the questions in each section before submitting

General
Proposer
Joint Proposer
Contact
The Property
Buildings
Contents
Security
Final Details
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General details

Renewal date / Cover date?	* A value is required.Looks too short for a date - e.g. 30/01/2009Looks too long for a date e.g. 30/01/2009
Renewal premium?
Where did you hear about us?	* We need to know this.We need a little bit more than that"That's slightly too much text

Questions marked with a * are mandatory

Please enter details about the main proposer

Title?
'Other' my title is?
First name?	* We need to know this detail.Your name is longer than this!That's too long for a name!
Surname?	* We need to know this detail.Your name is longer than this!That's too long for a name!
Date of Birth?
Occupation? (please give more details than self-employed, manager or director)	* A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Nature of your employer's business?

Questions marked with a * are mandatory

Please enter details about the joint proposer (if applicable)

Title?
'Other' my title is?
First name?
Surname?
Date of Birth?
Occupation? (please give more details than self-employed, manager or director)
Nature of your employer's business?

Please indicate how we may contact you

Preferred method of contact?
Contact telephone number?	*A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Email address?	*A value is required.Invalid format.

Questions marked with a * are mandatory

Please enter details about the property to be insured

House name / number?	* A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Postcode?	* A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Approximate year property built?	* A value is required.Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Year property was purchased?	* A value is required.Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Construction of the property?		*
Construction of the roof?
If any of the roof is flat please advise us of the approximate percentage?
Is the property?
What type of property?
If the property is a flat or maisonette, what floor is it on?
How many bedrooms?	*A value is required.
Is the property a listed building?
Do you share your home with lodgers?

Questions marked with a * are mandatory

Only answer the following questions if buildings cover is required

Rebuild value of the property?
Do you require accidental damage cover for buildings?

Questions marked with a * are mandatory

Only answer the following questions if contents cover is required

Contents sum insured?
Do you require accidental damage cover for contents?
If you have any valuables inside your home, such as pictures, works of art, televisions or computers worth individually over £1,500, please list with sums insured here:
Do you require 'Personal Possessions' cover for items taken away from the home?
If yes, please specify the amount of 'Unspecified Personal Possessions' taken away from the home:
If you require cover for any individual specified item(s) taken away from the home, including pedal cycles or money, please list with sums insured here:

Questions marked with a * are mandatory

Please answer the questions regarding security at the property

Are all external doors fitted with five lever mortice deadlocks or UPVC / aluminium doors fitted with a multi point locking system?		*
Are all accessible windows fitted with key locks?		*
Is there a burglar alarm fitted at the property?
If yes, please state what type, eg audible, central station, Redcare:

Questions marked with a * are mandatory

Has the proposer(s), or anyone living at the insured address:

Any unspent criminal conviction(s) or pending prosecution(s)?		*
Ever been declared bankrupt/insolvent or the subject of bankruptcy proceedings?		*
Ever had an insurance proposal declined, had a policy cancelled by an insurer, renewal refused or had special terms imposed?		*
Is the property located within 400 metres of a watercourse or previously been flooded?		*
Is the property currently undergoing structural renovation or is any structural work (excluding interior decorating) planned during the policy term?		*
Has the property ever been damaged by subsidence or ground heave, monitored for subsidence, showing any visible signs of cracking or been underpinned?		*
Are there any trees over 10 metres tall within 10 metres of the property?		*
Have you made any claims against a home insurance policy for this or any other property or has there been any incidents of damage or loss, within the past 5 years?		*
If you have answered 'Yes' to any of these questions, please give details, including dates, circumstances and if claim(s) the settlement amount(s).

Questions marked with a * are mandatory

Please check your form over and submit it to us

Please check all of the details. Once you are happy with the information provided, please click the submit button.

We will be in contact as soon as we have obtained a quotation. Thank you.

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