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© 2024 Prestige Insurance Brokers (UK) Limited

Risk questionnaire

for Property Owners
& Landlords

Please complete the form below to provide information about your property,
so we can assess the risk and offer you comprehensive insurance quotes

Please enable JavaScript in your browser to complete this form.

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Name of the person providing information within this form:

Phone number:

Email:

How many Owners / Directors and/or Partners the property business have in total?

1
2
3
4

1) Title & Full name / Date of Birth / Position within the business:

2) Title & Full name / Date of Birth / Position within the business:

3) Title & Full name / Date of Birth / Position within the business:

4) Title & Full name / Date of Birth / Position within the business:

Please choose from the following options below that apply to any Owner, Director or Partner:

have been declared bankrupt or insolvent or been a subject of bankruptcy proceedings
have been the subject of a recovery action by Customs and Excise or the Inland Revenue
had any non-motor conviction or criminal offences or any non-motor prosecutions pending
had a County Court Judgement awarded against them
Not applicable

Please choose from the following options below that apply to any Owner, Director or Partner:

had an insurance renewal refused
had an insurance cancelled by an insurer
had been asked to take extra precautions by insurers
had any special insurance terms imposed
Not applicable

Please select the property type to be insured:

Residential
Commercial
Industrial
Other

Please specify:

If there is any occupancy type split, please provide details and percentage of this occupancy split.

Business Name or Property owner name:

Trading name:

Please select the status of entity:

Date the business was established:

Address of the premises to be insured: (Property Name, Building Number, Street name, Town & Post code):

Please select relevant option to describe area of the property location:

Predominately residential
Predominately commercial
Predominately industrial

Please select if any following statements apply to the premises:

The property is not self contained with its own means of access
The premises is closed for more than 3 consecutive months
The property is unoccupied or has not been used in the last 30 days
Not applicable

Please select if any following statements are applicable to the premises:

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
Not applicable

Year the property was built?

Is the property listed?

Yes
No

Date of the property purchase:

Please provide details of the listing:

Would you like to have a correspondence address different from the risk address?

Yes
No

Please provide correspondence address (Property Name, Building Number, Street name, Town & Post code):

Total number of stories:

Is any of the stories of wooden construction?

Yes
No

Number of wooden stories:

Does the property have a basement?

Yes
No

Is the basement accessible to the public or is it used as a storage room?

Does the property have any garage?

Yes
No

Please provide details: (Single, Double or Multicar)

Number of rooms or internal partitions in total: (Please specify)

Total number of occupants:

Are the walls of the building constructed from:

Standard, one type of material
More than one type of materials

Please select the walls material from the options provided below:

Please specify what materials and describe percentage of each material used:

Does the building have a roof constructed from:

Standard, one type of material
More than one type of materials

Please select the roofing material from the options provided below:

Please specify what materials and describe percentage of each material used:

Is there any area of the roof flat?

Yes
No

Please state the approximate percentage of the roof being flat?

Please describe the materials used for floors, staircases and internal partitions:

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

Yes
No

What type of heating is currently installed in the property?

Please select the Risk Management Features that are currently active for this property:

Intruder Alarm
Fire Alarm
Fire Blankets
Fire extinguishers
Smoke detectors
Sprinklers
Regular Gas inspection
Regular Electrical inspection
Not applicable

Please select other Risk Management Features are currently active for this property:

Private CCTV (recording 30 days)
Other monitored CCTV
Access Control
Shutters
Window bars
Guard dogs
Security Patrols
Confidant living above
Not applicable

What type of signalling the intruder alarm has?

Redcare
Digicom
Bells only
Other

Is the alarm connected to the Police response?

Is the alarm being maintained by contracted Accreditation Approved Company?

Yes
No

Please provide details:

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

Yes
No

Sprinklers accreditation details:

Please specify type of door locks of the property:

Please specify type of window locks of the property:

Premises occupancy type:

Commercial
Residential
Commercial and Residential

Please provide details and percentage occupancy split:

Is the property a House in Multiple Occupation (HMO):

Yes
No

Is any part of the premises unoccupied?

Yes
No

Reason for unoccupancy:

Length of expected unoccupancy:

Date property first unoccupied:

Previous occupant type:

Percentage of the premises that is residential and unoccupied:

Percentage of the premises that is commercial and unoccupied:

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:

What is the estimated total value of the building? (Including Fixed Glass, Landlords Fixtures/Fitting)

Please provide the estimate based on the most recent survey.

Would you like to insure any specific valuables like Fine Art, Jewellery, Watches, Antiques, Collectables or Electrical items?

Yes
No

Please provide details of each specific item and it's value:

Do you have a safe in the property?

Yes
No

Please provide type of safe, make and model of the safe and the value of items stored in the safe.

Would you like to insure any valuables outside of the house such as additional buildings, garden furniture, ornaments?

Yes
No

Please provide details of each specific item and it's value:

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

Yes
No

What amount of Annual Rent would you like to cover?

Preferred Indemnity Period:

12 months
24 months
36 months

Have you had any losses or incidents giving rise to a claim in the last 5 years?

Yes
No

Claim history within the last 5 years: (If applicable)

Property insurance renewal date:

Current or previous insurer name:

Any addition information, would you like us to know?

GDPR Agreement *

I consent to having this form submitted so Prestige Insurance Brokers (UK) Ltd can respond to my inquiry.

We would like to assure you that we take data protection seriously and your privacy is important to us. We will process your data in accordance with GDPR.

Email

Rest assured, your information is held in strict confidence, ensuring your peace of mind.

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©2024

© 2024 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)