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Flood Re

Disclosure

Underwriter
Your Responsibilities:

You are responsible for answering any questions in relation to any proposal for insurance cover honestly and to the best of your knowledge, providing complete and accurate information which insurers will require. This also applies to your responses in relation to any assumptions you may agree to in the process of applying for insurance cover. This is particularly important before taking out a policy but also at renewal or if you make a mid -term amendment to your policy. If you fail to disclose information, or misrepresent any fact which may influence the insurer’s decision to accept the risk or the terms offered, this could invalidate the policy and mean that claims may not be paid. You must check all details on any proposal form or Statement of Facts and pay particular attention to any declaration you may be asked to sign.

It is important that you read all insurance documents issued to you and ensure that you are aware of the cover, limits and other terms that apply. Particular attention must be paid to any conditions as failure to comply with them could invalidate your policy.

You must inform us immediately of any changes in circumstances which may affect the services provided by us or the cover provided by your policy.

If you are unsure about any matter, please contact us for guidance.

Does the policyholder currently hold insurance?
Please provide date of last insurance held:
Please advise of the reason for no insurance:
You are the homeowner or tenant of the property to be insured. You are not a landlord.
Have you or any persons living with you ever been convicted of, or have a prosecution pending for any offence, other than a driving offence?

You do not have to declare any offence deemed to be SPENT under the Rehabilitation of Offenders Act 1974 amended by the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LAPSO).

Please provide full details:
Has any person to be covered by this insurance ever had an insurance contract cancelled, refused or declined by an insurer?
Please provide full details:
Has any person to be covered by this insurance ever had an insurance contract declared void by an insurer?
Please provide full details:
Has any person to be covered by this insurance ever had different terms applied to an insurance contract by an insurer due to misrepresentation by:

  • providing misleading or incorrect information

  • deliberately or recklessly withholding information

  • providing false documents

    • Please provide full details:
    Has any person to be covered by this insurance been declared bankrupt or insolvent either as private individuals or in connection with any business within the last ten years?
    Please provide full details:
    Has any person to be covered by this insurance been the subject of a County Court Judgement (or the Scottish equivalents) in respect of debt as private individuals or in connection with any business within the last six years?
    Please provide full details:

    Insured Details

    When would you like the policy to start?
    Should cover be required, this would form the start date of the policy (This cannot be more than 45 days from today)
    Client Name
    PolicyContactName
    Date of Birth
    Do you reside in the UK?
    What is your country of residence?
    Is your occupation any of the below?
    Antique Dealer | Professional Gambler | Professional Sportsperson | Firearms Dealer | Door Supervisor | Nightclub Owner | Oil Rig Worker | Furrier | Market Trader | Entertainer | Television Personality | Model | Journalist | Racing Drivers | Actor | Comedian
    Occupation
    Contact Number
    Mobile Number
    Email Address
    These details will be used to access your account area and all Policy Documentation will be sent to the Email Address you provide.
    Would you prefer your documentation & correspondence to be issued by email or post?
    Is there a Third Party Interest to be noted?
    Third Party Interest
    Is there a joint insured?
    Joint Insured Details
    Title
    First Name/s
    Surname
    Date of Birth
    Is the joint insured's occupation any of the below?
    Antique Dealer | Professional Gambler | Professional Sportsperson | Firearms Dealer | Door Supervisor | Nightclub Owner | Oil Rig Worker | Furrier | Market Trader | Entertainer | Television Personality | Model | Journalist | Racing Drivers | Actor | Comedian
    Occupation

    Premises Details

    What is the address of the property to be insured?
    How many years have you owned the property?
    Please provide full details:
    Approximately what year was the property built?
    What is the type of the property to be insured?
    What storey of the property is the flat situated?
    How many storeys does the property have, excluding any basement?
    Does the property have a basement?
    Please advise how the property is heated?
    What is the litre capacity of the tank?
    Is the tank Double Skinned (bunded)?
    Is the tank within 5m of any source of water, drains or gulleys?
    Is the tank less than 35 years old?
    Was the heating system (including tank) installed by an Oftec Approved Technician?
    Is the system on an annual maintenance agreement with an Oftec Approved Technician?
    Is the client willing to put in place a maintenance agreement with an Ofec Registered Technician?
    Are there any others residing on the premises that are not family members?
    Please provide full details:
    What is the wall construction of the property?
    Standard Construction is defined as walls built from brick/stone/concrete and roofed with slate/tile
    Please provide full details:
    What is the roof construction of the property?
    Standard Construction is defined as walls built from brick/stone/concrete and roofed with slate/tile
    Please provide full details:
    Is the property maintained and in a good state of repair?
    Please provide full details:
    Are there any building works in progress or planned in the next 12 months?
    Nature and type of building work to be undertaken?
    Approximate value (£) of the Building/ Contract works?
    £
    Will the works be carried out in accordance with Local Authority requirements and regulatory conditions?
    Please provide full details:
    When will the building work commence?
    Expected duration of the work/ building contract? (weeks)
    Is there a Joint Contracts Tribunal (JCT), or other formal building contract, in place for the duration of the work?
    Please provide full details:
    Are bone fide/ competent builders or contractors undertaking the works?
    Please provide full details:
    What is the limit of the contractors Public Liability coverage?
    £
    Planned usage for the property once works are complete, i.e. owner occupied/ main home, to be let out or sold?
    Has the property suffered from subsidence (downward movement of the site on which the buildings stand by a cause other than the weight of the buildings themselves)?
    Please provide full details:
    Has the property suffered from landslip (sudden downward movement of sloping ground)?
    Please provide full details, (including claims costs and if any surveys have been carried out):
    Has the property suffered from heave (upward and/or lateral movement of the site on which the buildings stand caused by swelling of the ground)?
    Please provide full details, (including claims costs and if any surveys have been carried out):
    Is the property showing any signs of cracking that may be due to subsidence, landslip or heave (such as internal and/or external cracks, movement or distortion)?
    Please provide full details (including claims costs and if any surveys have been carried out):
    Are you aware of any survey carried out on the insured property which mentions subsidence, settlement, cracking or movement to the building?
    Please provide full details:
    Are you aware of any neighbouring property that has been subject to an occurrence of subsidence, settlement, cracking or movement?
    Please provide full details:
    Are there any trees or shrubs within 7 metres of the property that are over 3 metres high?
    Please provide full details:
    To the best of your knowledge is there a willow tree within 40m of the property?
    Please provide full details:
    Has the property ever flooded?
    Please provide full details:
    To the best of your knowledge, is the property in an area which has a history of flooding?
    Please provide full details:
    Is the property within 400 metres of a watercourse?
    Please provide full details:
    What Council Tax Band is the property in?

    Please be aware that if this information is incorrect your policy will be invalidated.

    You can check here:- For properties in England and Wales

    You can check here:- For properties in Scotland

    England and Scotland: A - H

    Wales: A - I

    Northern Ireland: 1 - 8

    Will the property be unoccupied for MORE than 30 consecutive days or for a total of 180 days or more in a calender year?
    Please provide full details:
    Is the property used in connection with any business?
    What type of business is operated from the property?
    Will the public visit the premises in connection with the business?
    What is the maximum number of visitors to the property per week?
    Is cover for Business Property required?
    Defined as computers, keyboards, visual display units and printers, word processing equipment, desktop publishing units, multi-user small business computers, facsimile machines, photocopiers, typewriters, computer aided design equipment, telecommunication equipment and office furniture.
    Please state the figure required:
    £5,000 as standard, up to £10,000
    £
    Business Equipment Charge
    £
    Is cover for Business Stock required?
    Business Stock Amount required:
    Maximum £2,500
    £
    Where is the stock kept?
    Are any flammable gases or liquids kept on the property?
    Please provide full details:

    Cover Details

    Please state the Buildings Sum Insured required:

    This is the full rebuilding cost of the property, including the home and its decorations, fixtures and fittings attached to the home, permanently installed swimming pools, tennis courts, drives, patios and terraces, walls, gates and fences and fixed fuel tanks you own or for which you are legally responsible within the premises and named in the schedule.

    This also needs to be adequate to include architects', surveyors', consulting engineers' and legal fees, the cost of removing debris and making safe the building and costs you have to pay in order to comply with any Government or local authority requirements.

    If you are unsure whether this cover is adequate, you should contact a qualified surveyor.

    £
    Is Accidental Damage for Buildings to be included?
    Are there any outbuildings to be included within the buildings sum insured, that are not used for private or personal use?
    Please provide full details:
    Please state the Contents Sum Insured required:

    Household goods and personal property, within the home, which are your property or which you are legally responsible for, including tenant's fixtures and fittings, radio and television aerials, satellite dishes, wind turbines, solar panels, their fittings and masts which are attached to the home, property in the open but within the premises up to £500 in total (other than radio and television aerials, satellite dishes, wind turbines, solar panels, their fittings and masts which are attached to the home), deeds and registered bonds and other personal documents up to £1500 in total, stamps or coins forming part of a collection up to £1,500 in total, Gold, Silver, Gold & Silver plated articles and Jewellery up to £5,000 or 30% of the sum insured for contents whichever is the greater, (10% of the sum insured for contents for any one item) within the private dwelling, domestic oil in fixed fuel oil tanks up to £1,000.

    This excludes Fine Art, Antiques, Collectables, Jewellery and Watches over £1,500 Single Article Limit, which can be declared separately below.

    Territorial Limits - Great Britain and the Isle of Man

    £
    Is Accidental Damage for Contents to be included?
    Fine Art
    Please specify any item/pair/set over £1,500 or any item/pair/set to be covered outside the home
    £
    Specified Items:
    Please include make, model and value of each item.
    Antiques & Collectables, excluding collectable furniture
    Please specify any item/pair/set over £1,500 or any item/pair/set to be covered outside the home
    £
    Specified Items:
    Please include make, model and value of each item.
    Photographic Equipment
    Please specify any item/pair/set over £1,500 or any item/pair/set to be covered outside the home
    £
    Specified Items:
    Please include make, model and value of each item.
    Furs
    Please specify any item/pair/set over £1,500 or any item/pair/set to be covered inside the home only
    £
    Specified Items:
    Please include make, model and value of each item.
    Is personal possessions cover required?

    This includes clothing, baggage, sports equipment and other similar items normally carried about the person and all of which belong to you, excluding Jewellery and Electronics.

    Personal Effects
    Please specify any item/pair/set over £1,500
    £
    Specified Items:
    Please include make, model and value of each item.
    Do you wish to cover any items of jewellery away from the home or any item/pair/set with a single article limit over £1,500?
    Unspecified Jewellery & Watches

    This includes all items under the value of £1,500

    Please include any item/pair/set over £1,500 within 'Specified Jewellery & Watches' below

    £
    Specified Jewellery & Watches
    Please specify any item/pair/set over £1,500 below
    £
    Specified Items:
    Please include make, model and value of each item.
    Electronics, including Audio & Video Equipment, Computers & Mobile Phones, including their components and accessories (excluding printers, scanners & faxes)
    Please specify any item/pair/set over £1,500 and/or any mobile or tablet device over £500
    £
    Specified Items:
    Please include make, model and value of each item.
    Pedal Cycles (£200 as standard, per bike)
    Please specify all Pedal Cycles
    £
    Specified Items:
    Please include make, model and value of each item.
    Money Cover
    Maximum £500
    £
    Credit Cards
    Maximum £500
    £
    Frozen Foods
    £
    Public Liability
    £
    Do you require Home Emergency cover?

    Cover includes all of the following domestic emergencies:-

  • the complete breakdown of your heating system

  • plumbing and drainage problems

  • damage which effects your security, including locks and windows

  • if your only toilet is broken

  • loss of your power supply

  • lost keys

  • vermin infestation

    • This is charged at £35.00 plus Insurance Premium Tax

    The following information is captured to calculate exposure for insurers, and does not affect the premium or coverage:
    To the best of your knowledge, what is the rebuild cost of this property?
    £
    To the best of your knowledge, what would be the cost to replace all contents in this property?
    £
    Set Strategy Load @ % £0.00
    Set + Auto Load £ £0.00
    Set Claims Load @ % £0.00
    Set Ireland Load @ % £0.00
    Set Discretionary Disc @ % £0.00
    Set Discretionary Load @ % £0.00
    Set Listing Load @ % £0.00
    Set FloodRe Discount @ % £0.00
     
    Flood Re Buildings
    £
    Flood Re Contents
    £
     
    ARAG Legal
    £
     
    ARAG Home Emergency
    £
     

    Security

    Have all of the doors and windows been fitted with the following:
    External doors secured by a mortice deadlock or a deadlock conforming to British Standard 3621 or by a multi-point locking system with either a lever or built-in deadlocking cylinder or key-operated security bolts fitted internally to the top and bottom?
    All accessible windows, fanlights and skylights fitted with key operated window locks?
    All outbuildings fitted with BS3621 locks and / or close shackle padlocks?
    Is there an alarm installed on the property?
    Has the alarm been professionally installed?
    Is there an annual maintenance agreement in place with an approved installer?
    Is there any other security features at the property?
    Please provide full details:
    Is there a safe on the property?
    Please provide full details: Make, Model, Cash Rating etc.

    Claims

    Have you or any persons living with you, ever sustained any loss, damage, injury or liability in the last five years, whether insured or not?
    Please provide details:
    Date Details PaidReserveMeasures Taken
    Add row
    Action taken to prevent similar loss(es) occurring again:

    Additional Information

    Do you want to bring any further information to the underwriters attention?
    Please provide full details:
    Where did you hear about us?
    If you have a discount code, please enter it here:
    Hiscox Referral Reason:
    Policy Reference of Referral
    Would you like us to contact you to discuss any of your other insurance needs?
    Life | Travel | Commercial | Residential and/or Commercial Property
    Please provide details of the insurances you would like to discuss, including renewal dates if applicable:
    How much do you currently pay for your insurance?
    £
    Stay in touch...

    We'll automatically email you your quotation, including a link so you can easily retrieve all your quotes. We'd like you to be the first to know about latest offers, news, products and promotions. You can let us know at any time if you change your mind. Further information can be found in our privacy policy which will be included in your quotation pack.

    You'll receive newsletters full of interesting news and money saving ideas and other information about our other products and services that we think you'll be interested in. We may keep in touch via email, SMS, phone, post and other electronic means such as via social and digital media.

    Would you like to receive these updates from us?

    Rates

    Start Rate
    Area Rate
    Accidental Damage Rate
    Property Rate
    Age of Property
    Wall Construction
    Roof Construction
    Bedroom Rate
    Age Rate
    NCD Rate
    Previous Subsidence
    Buildings & Contents
    Answer 0
    Answer 1
    Answer 2
    Answer 3
    Answer 4
    Answer 5
    Answer 6
    Answer 7
    Answer 8
    Answer 9
    Answer 10
    Start Rate Contents
    Contents Rate
    AD Contents Rate
    Bedroom Contents Rate
    Age Contents Rate
    NCD Contents Rate
    Buildings & Contents
    Answer A
    Answer B
    Answer C
    Answer D
    Answer E
    Answer F

    Information

    Postcode Used For Lookup
    Risk Postcode
    Area Code From Lookup (Hiscox)
    Contents Code From Lookup (Hiscox)
    Flood Check From Lookup (Hiscox)
    Flood Area (Hiscox)
    Area Code From Lookup (HCC)
    Contents Code From Lookup (HCC)
    Flood Code From Lookup (HCC)
    Theft Code From Lookup (HCC)
    Subs Code From Lookup (HCC)
    Security Code From Lookup (HCC)
    Message From Lookup (HCC)

    Please complete the below:

    Endorsements
    3 Digit Endorsement Code. Separate each endorsement with the | delimiter
    Castle Quote Reference
    Excluded Cover
    Reason for Non-Standard
    House Number
    House Name
    Standard Excess
    £
    Escape of Water Excess
    £
    Flood Excess
    £
    Subsidence Excess
    £
    Is Subsidence included?
    RiskAlliance Rewards (NO LONGER AVAILABLE)
    Hiscox Reference
    Hiscox Policy Reference
    Cancellation Reason
    Where did this Hiscox lead come from?
    Reason Not Taken Up (for Hiscox)

    Flood Re

    Property Type
    Wall Construction
    Roof Construction
    Buildings Coverage Type
    Contents Coverage Type

    Please complete the following if Flood Re is included:

    Flood Re ID
    Flood Re Annual Premium Buildings
    £
    Flood Re Annual Premium Contents
    £