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© 2025 Prestige Insurance Brokers (UK) Limited

Fact-finding questionnaire to request an insurance quote

for Landlords & commericial Property Owners

Let’s Secure Your property Today!

Fill out the form below, and one of our insurance expert will be in touch for a quick consultation and a tailored insurance quote designed just for your needs.

Submit your details below & get the protection your property deserves!

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Contact Name

Email

Phone number

Please provide a correspondence address (If it is different from the address being insured)

Insurance Renewal date

Current insurer

Premium target

Property Ownership Name(s) as it appears on the Land Registry Title Deeds

Date property purchased

Please provide: Full name / Date of birth / Job title / Occupation for all Owners, Directors or Partners:

Please indicate if any owner, director, or partner has ever:

had an insurance policy cancelled
had a policy renewal refused
had a proposal refused or declined
had special terms imposed on an insurance policy
Not applicable (No adverse insurance history)

Please indicate if any owner, director, or partner has ever:

been disqualified from holding company directorship
been declared bankrupt or insolvent
had a County Court Judgment awarded against them
had any conviction or criminal offence
Not applicable (No disqualifications or legal history)

Full address of the premises to be insured

(Property Name, Building Number, Street name, Town & Post code)

Year property built

Is the property mortgaged?

Yes
No

Name of the mortgage provider

Is the property a Listed Building?

Yes
No

Please provide details of the Listing

Please indicate which of the following conditions apply to the premises:

The property is not self contained with its own means of access
The property is erected on made up ground or has been underpinned
The property is in area with history of flooding
The property is unduly exposed to storms or high winds
The property is close to mines/underground workings
The property has suffered from, or shows any visible signs of damage subsidence, landslip or ground heave
Not applicable ( No environmental risk factors)

Is the premises in a good state of repair and free from damage?

Yes
No

Is the property of non-standard construction?

Yes
No

(Walls not built only of brick, stone, concrete or roofed only with slates, tiles, or concrete)

What is the total number of storeys in the building?

Number of storeys where floor is of concrete construction?

Number of storeys where floor is of wooden construction?

Does the property have a basement?

Yes
No

What main materials are the property walls made of?

Please provide percentage split, if the walls are made of more than one material

Does the premises have external cladding/external wall insulation?

Yes
No

What materials is the property roof made of?

Please provide percentage split, if the roof is made of more than one material

Is there any area of the roof flat?

Yes
No

Please state the percentage of the roof being flat and describe the material used to cover that part of the roof

What type of heating is currently installed in the property?

Is there an ATM on the premises?

Yes
No

Any Risk Management Features that are currently active for this property:

Intruder Alarm
Wired Fire Alarm
Smoke detectors on each floor
Sprinklers
Gas inspections
Electrical inspections

What type of signalling the Intruder Alarm has?

Redcare
Digicom
Bells only
Other

Is it connected to the Police response? If yes, what level?

Is this Intruder Alarm being regularly maintained by contracted Accreditation Approved Company?

Yes
No

Please provide details:

Is the sprinkler installed with a water supply?

Yes
No

Sprinkler's accreditation details:

Is the sprinkler maintained by Loss Prevention Certification Board approved company?

Yes
No

Premises occupancy type:

Commercial
Residential
Commercial and Residential

Type of building: (Detached, Semi-detached, Terraced, Other, please specify)

Number of bedrooms, bathrooms and other rooms in the residential area of the premises

Number of all tenancies and all trades in the commercial area of this premises:

Number of tenancies and type of tenants in the residential area at the premises: (I.e: Working tenants, Students, Benefit Assisted)

Please specify

Is any part of the property a House in Multiple Occupation (HMO)?

Yes
No

Any parts of the premises unoccupied?

Yes
No

Reason for unoccupancy

Length of expected unoccupancy

Percentage of the premises that is unoccupied

Date property first unoccupied

Previous occupant type

Please select immediate intention for the property:

Letting
Development
Demolition
Owner occupied
Sale
Unknown

Any type of work planned?

Decoration
Extension construction
Central heating installation
Conversion to private dwelling
Kitchen/Bathroom refit
Major structural works
Non-structural major refit
Refurbishment/Renovations
Replacing windows
Replumbing
Rewiring
None

Is planning permission granted?

Yes
No

Contract works value (£)

Type of structural works:

Reinstatement sum of the building (Including Fixed Glass, Landlords Fixtures & Fittings)

Please provide the estimate based on the most recent rebuild cost assessment.

Would you like to cover any loss of rental income in case of unexpected interruption to the property income?

Yes
No

Annual rent that you require to be covered

What would be the preferred length of time for the Loss of Rent Cover? (Indemnity Period)

12 months
24 months
36 months
Not required

The standard liability limit of indemnity for property owners is £2 million. Would you like to increase it to £5 million?

Yes
No

Has any owner, director or partner of the business either personally or in any business capacity in the last 5 years sustained any loss or had any claims made against them?

Yes
No

Please provide the details of the claims made: (Date of claim, Cause of the Claim, The Claim Amount & the Outcome)

Is any owner, director or partner aware of incidents that might result in a loss or claim, that are relevant to any cover available with this class of business?

Yes
No

Any additional information we should be aware of?

Data Protection Agreement *

By ticking this box, I give my consent to the collection, processing, and storage of my personal data by Prestige Insurance Brokers (UK) Ltd for the purpose of providing commercial insurance services.

I understand that my data will be handled in accordance with the GDPR and Prestige Insurance Brokers’ Privacy Policy. I may withdraw my consent at any time by contacting info@prestigeinsuirancebrokers.com.

Comment

Rest assured, your information is held in strict confidence.

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© 2025 Prestige Insurance Brokers (UK) Limited - Appointed Representative of TEn Insurance Services Ltd, trading as Eleven, which is authorised and regulated by the Financial Conduct Authority (FRN 314593)