Change of Occupancy to Main Residence

Please answer the questions carefully and to the best of your knowledge, as our quotation will be based on the details you provide. Incorrect information could lead to an increased premium, claim being declined or invalidate an insurance.

Step 1 of 6 - Start

Our 8-digital reference number?*

Type of cover required for a quote?*

Change of occupancy quote date?*

Occupancy of the property to be insured?*

Select from the drop down box

Total number of lodger(s) at any one time?*

Does the property to be insured have an annexe?

Occupancy of the annexe to be insured?*

Enter your details as the policyholder, with option to add a joint policyholder

Name?*

Title First name Surname

Email address?*

Enter Email Confirm Email

Telephone number?*

Please enter a valid phone number in UK format, starting 07, 01, 02 or +44, with no spaces

Joint policyholder (optional)

Joint policyholder?

Name?*

Title First name Surname

The insured property address?*

Enter postcode, then select address from drop-down

Postcode 1st line 2nd line Town / city Postcode

Contents insurance, with option to also include cover away from home

CONTENTS sum insured?*

Input your sum insured

Accidental damage cover for contents?

Contents voluntary excess (with a premium discount)?*

Valuables single item(s) over £1,500 within your home?

Valuables defined as gold, silver, pictures, works of art, stamp and coin collections, televisions, audio and home computers with single item value over £1,500 kept within your home only

LIST VALUABLES OVER £1,500 WITHIN YOUR HOME*

Description of each item or set over £1,500

New Value £

Description example:
Diamond and platinum ring ✔
Ring ❌
Click on ⨁ sign to add extra item(s)

DO YOU REQUIRE COVER AWAY FROM HOME?*

Jewellery, watches, personal possessions worn or carried about your person, bicycles, personal money and cards

UNSPECIFIED POSSESSIONS AWAY FROM HOME*

If required select a sum insured

SPECIFIED ITEMS AWAY FROM HOME*

Jewellery, watches, cameras over £1,500. Mobile phones and computers over £750. Hearing aids of any value.

LIST SPECIFIED ITEMS AWAY FROM HOME*

Description of each item or set

New Value £

Description example:
Diamond and platinum ring ✔
Ring ❌
Click on ⨁ sign to add extra item(s)

BICYCLES AWAY FROM HOME*

LIST BICYCLES AWAY FROM HOME*

Make and model of each bicycle

New Value £

Input details in each box, as missing information will mean we cannot quote
Click on ⨁ sign to add extra bicycle(s)

PERSONAL MONEY AND CARDS AWAY FROM HOME?*

Error - cannot proceed

You asked for cover away from home, but said not required to the 4 options

About the property and the occupancy

Is the property in a good state of repair and to your knowledge, free from damage or defect and will you continue to maintain it properly in the future?*

Will the main property be unoccupied for a continuous period exceeding 60 consecutive days?*

Please give details*

Will any trade or business be carried out in your property?*

Do you plan on carrying out any renovations, conversions, extensions or other structural alterations to the property in the next 12 months?*

Please give details*

This field is hidden when viewing the form

IMPORTANT INFORMATION WHICH MUST BE READ IN FULL

The information contained in this Statement of Fact forms the basis of your policy and is fundamental to the risk assumed by the Insurers. You must notify Ember JD Insurance Brokers immediately if any of the above details are incorrect as your cover might be invalidated if you do not.
Misrepresentation
We declare that to the best of my knowledge and belief the information I/We have provided in connection with this proposal to Ember JD Insurance Brokers, whether in my own hand or not, is true and complete and I/We have not withheld or misrepresented any information. I/We ask underwriters to act upon the information provided and issue a contract of insurance between us and I/We agree to accept underwriter’s policy terms, conditions and exclusions. I/We consent to the seeking of information from other insurers to check the answers I/We have provided and I/We authorise the giving of such information for such purposes. I/We understand that if I/We have withheld or misrepresented any of the information contained in this proposal, underwriters may be entitled to void the insurance.
Data Protection Act 1998
By accepting this Statement of Fact you consent to Ember JD Insurance Brokers using the information we may hold about you for the purpose of providing insurance and handling claims, if any, and to process sensitive personal data about you where this is necessary (for example, health information or criminal convictions). This may mean we have to give some details to third parties involved in providing insurance cover. These may include insurance carriers, third party claims adjusters, fraud detection and prevention services, reinsurance companies and insurance regulatory authorities. Where such sensitive personal information relates to anyone other than you, you must obtain the explicit consent of the person to whom the information relates both to the disclosure of such information to us and its use by us as set out above. The information provided will be treated in confidence and in compliance with the Data Protection Act 1998. You have the right to apply for a copy of you information (for which we may charge a small fee) and to have any inaccuracies corrected.
Basis of Cover
I understand that my acceptance of this Statement of Fact does not bind me to complete the insurance but agree that, should a contract of insurance be concluded, this Statement of Fact and the statements made in it and the information provided in connection with it will be relied upon by the underwriters in deciding whether to accept this insurance.
Your records
You should keep a record (including copies of any letters) of all information supplied to Ember JD Insurance Brokers for the purpose of entering into this insurance.
Change in Circumstance
You must inform Ember JD Insurance Brokers of any change in circumstances which may affect this insurance. If you are in any doubt you should consult Ember JD Insurance Brokers.
E.U. Disclosure Clause (UK)
Notice to the Proposer / Insured: The parties are free to choose the law applicable to this insurance contract. Unless specifically agreed to the contrary this insurance shall be subject to English Law.
Complaints
Any enquiry or complaint should be addressed in the first instance to your broker, Ember JD Insurance Brokers. The process for complaining directly to Lloyds can be found in the Complaints section of your Policy Wording.
The Financial Ombudsman
If you are still not satisfied with the way a complaint has been dealt with you may ask The Financial Ombudsman to review your case without prejudice to your rights in law. You can contact The Financial Ombudsman at:
The Financial Ombudsman Service
Exchange Tower
London
E14 9SR
Telephone: 0800 023 4567
www.financial-ombudsman.org.uk.

Enter your details as the policyholder, with option to add a joint policyholder

Joint policyholder (optional)

Buildings insurance

Contents insurance, with option to also include cover away from home

Security details

About the property and the occupancy

Property types

○ Commercial Property Insurance
○ Flats Insurance
○ Maisonettes Insurance

Occupancy types

○ Home & Annexe Insurance
○ Let Home Insurance
○ Unoccupied Home Insurance

Specific types

○ Home & Garden Room Insurance
○ Leaseholders Improvements Insurance
○ Single Flat Buildings Insurance

Enter your details as the policyholder, with option to add a joint policyholder

Joint policyholder (optional)

Buildings insurance

Contents insurance, with option to also include cover away from home

Security details

About the property and the occupancy

Property types

○ Commercial Property Insurance○ Flats Insurance○ Maisonettes Insurance

Occupancy types

○ Home & Annexe Insurance○ Let Home Insurance○ Unoccupied Home Insurance

Specific types

○ Home & Garden Room Insurance○ Leaseholders Improvements Insurance○ Single Flat Buildings Insurance

○ Commercial Property Insurance
○ Flats Insurance
○ Maisonettes Insurance

○ Home & Annexe Insurance
○ Let Home Insurance
○ Unoccupied Home Insurance

○ Home & Garden Room Insurance
○ Leaseholders Improvements Insurance
○ Single Flat Buildings Insurance