Buildings & Contents Form

UKI&Ireland Logo

Please fill in the form below, as fully as you can and we will contact you as soon as possible. Thank you.

Personal Details

Full Name
Date of Birth
Telephone No.
Mobile Phone Number
Email Address
Address line1
Post Code

Cover Required

Do you require Accidental Damage cover

Buildings Sum Insured
Contents Sum Insured
Policy Excess Required
Existing Insurer

Property Details

Type of Building
Year of Building
Number of Bedrooms
Number of Residents

If there are any comments or details which you think may affect your application for insurance (such as previous claims), please give them here.



Please read carefully and confirm that you can agree to these conditions.

  • An insurance company has never cancelled one of your policies, applied special terms when renewing your policy or refused to renew your policy.
  • All buildings are of standard construction (i.e. brick or stone walls and tile or slate roof and is not a listed building).
  • All buildings are occupied regularly, throughout the year
  • All premises show no signs of damage from subsidence, landslip or groundheave, and has never suffered from any of these problems
  • All premises to be insured are not in an area that to the best of your knowledge or due enquiry, has a history of flooding,
  • And no claims have been made on the property in the last three years.

I agree to the above conditions