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© 2024 Prestige Insurance Brokers (UK) Limited

Fact find questionnaire

for Property Owners
& Landlords

FILL OUT THE FORM BELOW TO GET AN INSURANCE QUOTE

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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

Property Ownership Name

Land Registry Title

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

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

Please select from the following options 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

Full address of the premises to be insured

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

Year property built

Date property purchased

Is the property a Listed Building?

Yes
No

Please provide details of the Listing

Please select from the following options that 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

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 approximate percentage of the roof being flat?

What type of heating is currently installed in the property?

Is there an ATM on the premises?

Yes
No

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

Intruder Alarm
Wired Fire Alarm
Fire extinguishers
Smoke detectors
Gas inspections
Sprinklers
Electrical inspections
Planned maintenance program

What type of signalling the Intruder Alarm has?

Redcare
Digicom
Bells only
Other

Is the Intruder Alarm connected to the Police response?

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

Yes
No

Please provide details:

Are the sprinklers installed with a water supply?

Yes
No

Are the Sprinklers maintained by Loss Prevention Certification Board approved company?

Yes
No

Sprinklers accreditation details:

Please select Security Aids that are currently active for this property:

24h Site Security
Access Control
Guard dogs
Private CCTV (recording 30 days)
Other monitored CCTV
Shutters
Security Patrols
Confidant living above
Not applicable

Premises occupancy type:

Commercial
Residential
Commercial and Residential

What is the total number of tenancies on this premises?

Please specify all tenancies and trades in the commercial area of the premises:

Please specify number of tenancies and type of tenants in the residential area on the premises:

I.e: Working tenants, Students, Benefit Assisted)

Is any part of 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

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:

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

Please provide the estimate based on the most recent survey.

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

Yes
No

What is the 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

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

Yes
No

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

Yes
No

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

Any additional information?

GDPR Agreement *

I consent to having this form submitted and agree for Prestige Insurance Brokers (UK) Ltd to respond to my enquiry by phone, email or messages.

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Name

Rest assured, your information is held in strict confidence.

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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)