High Net Worth Insurance Quote

Please Read

Before we can provide a quote, we must tell you certain information about ourselves, and also ask certain information about yourself.

Information about us

Coversure Insurance Services is an insurance intermediary. We provide insurance for vehicles, homes and business insurance, based on a fair analysis of the market. Further information about Coversure is available in our terms of business. If you request a written quote or take out a policy through us, you will be provided with this information in writing in any case. If you have any complaints about our service, please refer to the complaints section in the terms of business.

Getaquote Limited t/as Coversure Insurance Services (Hull) is authorised and regulated by the Financial Services Authority. Ref. 448461. You can check this at the FSA's website here.

Our registered Office is: Coversure House, Hibel Road, Cheshire SK10 2AB. Registered in England Number. 5651258.

Information about you

In order to provide you with a quote, we will need you to answer a few questions. It is important that you answer the questions carefully and accurately because if the questions are not answered truthfully or you provide incorrect or incomplete information, the insurance company might decide that the insurance is invalid and this may affect any claim that you make. If you do take out a policy with us, you must also inform us of any changes in your circumstances during the period of cover.

Has the proposer or any person named on this policy been refused insurance or had a policy cancelled by an insurance company, or had any special terms imposed?				No
Has the proposer or any person named on this policy ever had a county court judgement against them?				No
Has the proposer, director or partner of the business or practice ever been declared bankrupt?				No
Has any proposer, director, partner of the business/practice or person named on this policy had any convictions, criminal offences or prosecutions pending other than motor offences?				No
Would you prefer your quote based on price, cover, claims or a combination?
I confirm I have read the terms of business.

Your Details
Title		Name	A value is required.
Your Sex	Male Female Please make a selection.	Surname	A value is required.
Date of Birth	A value is required.	Email Address	A value is required.Invalid format.
First Line of Address	A value is required.	Postcode	A value is required.
Best Contact Number	A value is required.	Alternative Contact Number
Employment Status	Please select a valid item.	Employer's Trade
Your Occupation	A value is required.	Married?	Please select a valid item.
Spouse's Date of Birth		Spouse's Employment Status
Occupation of your Spouse		Employer's Trade for your Spouse
Your Cover
Buildings (rebuild cost)	A value is required. (inc. outbuildings)	Buildings Accidental Damage	Yes No
Bedrooms		Year Built
Construction		Roof construction
House type		Flat Roof Area
Occupied		General contents value £
Unspecified All Risks £		Specified All Risks £ (please itemise)	none
China, Glassware & Porcelain		Specified All Risks £ (please itemise)	none
Pedal Cycles		Contents Accidental Damage	Yes No
Money Cover		Frozen Food Cover £
Jewellery (inc. watches) worn £		Jewellery never worn £
Guns & equipment £		Furs and designer clothing £
Antique & designer furniture £		Fine Art & other Antiques £ inc. gold & silverware (not jewellery)
Paintings, drawings, maps, prints, photographs, books, tapestries, and rugs
Clocks, barometers, curios, statues, sculptures, stamps, coins, medals, and other collections
Buildings No Claims (years)		Contents No Claims (years)
Your Security
Smoke Alarms	Yes No	External Door Lock type
Key operated window locks	Yes No	Burglar Alarm
Is the alarm on a maintenance contract?	Yes No No Alarm fitted	Is there a neighbourhood watch?	Yes No
Is there any other security? Please give details:	none	Is there are safe on the property? Please give make & model	no safe

Your Property
Is the building listed?		Is the property self contained?	Yes No
Is the property your main home?	Yes No	Is the property solely occupied by family members?	Yes No
Is the property used for business at all?		Do you ever have business visitors?	Yes No
Is any part of the property sub let?	Yes No	Do you employ any domestic staff?	Yes No
Is the property tidy and in a good state of repair?	Yes No	Is the property near any cliffs, quarries, mines, or anything of that nature?	Yes No
Is the property within 200 yards of any watercourse?	Yes No	Has there been any previous flooding history?	Yes No
Who is the property owned by?		Any history of subsidence, heave or landslip?	Yes No
How long has the proposer lived here?		Any special requirements? (e.g. legal cover)
	What has 4 legs and goes "moo" (3 letters)