Vasek Insurance - Specialist Property Insurance

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Initial Details Policyholder Details Property Details Additional Details Cover Required General Questions Terms and Conditions

Policyholder Details

Is the policyholder an individual or a company/organisation

Who is this quote for? *

A company

An individual

Company name *

Company contact title *

Company contact first name *

Company contact last name *

Search for address or postcode

Is this address in the UK? *

Yes

Correspondence address *

Country *

Email address *

Contact telephone no. *

Main policyholder details:

Title *

First name *

Last name *

Date Of Birth *

Occupation *

Email address *

Contact telephone no. *

Do you have a different correspondence address? *

Yes

Search for address or postcode

Is this address in the UK? *

Yes

Correspondence address *

Country *

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General Questions

Have you or any other person whose property or belongings are to be insured sustained any loss or damage in the last 5 years that would have been covered by this type of insurance had it been in force, whether or not a claim was made or paid? *

Yes

Claim Number 1 details:

Date of loss *

Please select the type of loss from the list *

Under what sections of the insurance was the claim made against? *

Amount of Loss or Damage for Buildings *

Amount of Loss or Damage for Contents *

Please provide full details of the loss, including (if applicable) full cause, extent of damage and measures in place to prevent recurrence *

Did the loss occur at the address to be insured? *

Yes

What was the outcome of the claim? *

Claim paid by the insurer (including when a partial recovery was made)

Claim paid but a full recovery was made

Claim made but withdrawn by the insured as the cost fell below the policy excess

Claim made but repudiated / declined by the insurer as the policy would not have provided cover

Claim made but repudiated by the insurer as there was a breach of policy conditions

Add another claim Remove this claim

Has any insurer declined to accept, cancelled, refused to continue or agreed to continue only on special terms or with an increased premium any insurance for any person to whom this insurance would apply? *

Yes

Have you or any other person living at the home (except children under the age of 18) ever been convicted of a criminal offence (that is not deemed as spent under the Rehabilitation of Offenders Act 1974, amended March 2014)? *

(basic motoring offences and convictions considered spent under the Rehabilitation of Offenders Act need not be disclosed, please click the information icon for details of when convictions are considered spent)

Yes

Conviction Number 1 details:

Name of person with conviction *

Date of Conviction *

Conviction Type *

Was a custodial sentence given? *

Yes

Was a fine imposed? *

Yes

Was a community order imposed? *

Yes

Is there any further information you wish to supply regarding the conviction? *

Yes

Add another conviction Remove this conviction

Do you or any other person living at the home (except children) have any unsatisfied CCJs or IVAs from the last 3 years? *

Yes

Do you or any person living at the home (except children) have any undischarged bankruptcies from the last 3 years? *

Yes

Please state any target premium

Would you like to provide any further information? *
Please only add information into this box if you have relevant rating messages, as when something is noted in this box it will automatically need reviewing.

Yes

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Terms and Conditions

Contact Preferences

We’d like to tell you about our products or services that may interest you. Please tick if you would like to hear about these products and services by:

Email
SMS
Telephone (live)
Post

We or our group companies may also send you details of the products and services of our group companies.

Please tick if you would like to hear about these:

You can opt out of marketing communications at any time by contacting us.

Important Notice

The information you have provided in this submission contains statements upon which we will rely when deciding whether to accept this insurance and the terms on which it may be offered, including the amount of premium payable.

It is very important that the information is complete and accurate. If you are in any doubt at all regarding any of the answers given, you should ask us or your insurance broker.

If any of the information provided by you changes after you purchase your policy or during the period of your policy you must immediately provide us with details of the changes.

We act on a ‘non-advised’ basis which means that we will offer you information about the significant features, benefits, limitations and exclusions of a particular insurance policy(ies), but it is for you to decide by assessing the features, benefits and conditions which of these best suits your requirements. When acting on a ‘non-advised’ basis, we act as Agent of the Insurer (that is to say, we represent the insurer).

This insurance policy is underwritten by a consortium of the following insurers, led by HCC International Insurance Company plc (HCCII) trading as Tokio Marine HCC. This company is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

Declaration

To the best of my/our knowledge and belief all statements and information provided in connection with this insurance, either orally, electronically or in writing, are true. I/we understand that non-disclosure or misrepresentation of any of the answers given may entitle underwriters to:-

cancel my/our policy and refuse to pay any claim, or
not pay any claim in full, or
revise the premium and/or change any excess, or
revise the extent of cover or terms of the insurance.

I agree*

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For information on how we use your personal data please refer to our UK Privacy Notice

Need a little extra support? We’re here to help.

Being aware of any challenges our customers are facing can help us to consider our approach and offer appropriate support where it’s needed.
Should you need support or assistance please contact us on 0115 9505052

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