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Renters Contents and Liability Insurance

Tenant 1

help

Are you a student?

Yes

No

Title

First Name

Last Name

Date of Birth

Email Address

Mobile Number

I/We meet all of the following eligibility criteria

Neither I, or anyone to be insured under this policy, have any unspent convictions or prosecutions pending (other than motor convictions).

Neither I, or anyone to be insured under this policy, have had insurance cancelled, declined, declared void or had any special terms imposed as a result of non-disclosure of information, fraudulent activity or misrepresentation, whether intentional or not.

The property will not be left unoccupied for more than 60 days in a row.

The property will not be used for business or professional purposes, other than clerical work.

Do you confirm that you meet the above eligibility criteria? (for further terms and conditions please refer to the policy document which can be found on the next stage once your quote is generated.)

Yes

No

You must meet all the eligibility criteria to continue

Have you, or anyone else to be insured under this policy, made any contents insurance claims in the last 5 years?

Yes

No

Rent Property Address

Postcode

Number of bedrooms?

Please Select

Property type?

Please Select

Amount of contents cover required?

Please Select

Would you like accidental damage on your contents insurance?

Yes

No

What is your current no claims discount for contents?

Please Select

Select your contents excess

Please Select

Would you like to cover any items away from the home, such as gadgets, mobiles, jewellery or bikes?

Yes

No

Would you like cover for legal expenses up to £100,000?

Yes

No

Do you have any valuables worth more than £2,500 within the home?

Yes

No

Policy Start Date

Date

Contents and Liability Insurance

Your personalised quote for

For more info:
Insurance Product Info Document
Status Disclosure Document
Policy Booklet

Telephone number

Tenant 1

I would like to receive my documents by

Email

Email and Post

Do you wish to specify a correspondence address?

Yes

No

Please read carefully the statements below

Neither I, or anyone to be insured under this policy, have any unspent convictions or prosecutions pending (other than motor convictions).

Neither I, or anyone to be insured under this policy, have had insurance cancelled, declined, declared void or had any special terms imposed as a result of non-disclosure of information, fraudulent activity or misrepresentation, whether intentional or not.

The property will not be left unoccupied for more than 60 days in a row.

The property will not be used for business or professional purposes, other than clerical work.

Have you read all the above statements?

Yes

No

Please confirm you have read the above statements to continue

^*All prices are inclusive of Insurance Premium Tax (IPT)

Bank Account Name

Account Name

Sort Code

Preferred Direct Debit Date

This is the date your payments will be taken from your account

INSURANCE DECLARATION

Your information will be submitted electronically to Paymentshield and therefore your signature is not required on the declaration or the direct debit mandate.

You are reminded you are responsible for the answers given in this application and that you must have taken reasonable care to answer all questions honestly, to the best of your knowledge, providing full answers and all relevant details. If you did not answer the questions honestly or to the best of your knowledge, then your policy may be cancelled or your claim rejected or not fully paid.

FAIR PROCESSING NOTICE – USING YOUR PERSONAL INFORMATION

Before we continue, we need to let you know that Paymentshield are committed to keeping your information safe and secure, and will use your personal information to communicate with you and to provide you with the products and services you need or are of interest.

Paymentshield share information with other companies including insurers and finance companies to assess and obtain the quotes and covers you may need and may check information against publicly available sources. Paymentshield also share information with other organisations where it needs to do so by law.

Paymentshield’s Fair Processing Notice can be found on its website which explains in more detail how they use and share your personal information, your rights to access and amend the information Paymentshield hold on you and how to make contact.

Please confirm that you have read these declarations and have been provided with and have the opportunity to read the Insurance Policy Booklet, the Status Disclosure Document, the Insurance Product Information Document, the Quote Summary and are happy to proceed.

Yes, I agree

No, I disagree

You must agree to continue

By clicking on "Complete" you confirm that you have read and agreed to the terms of use and the privacy policy.

^*All prices are inclusive of Insurance Premium Tax (IPT)

Renters Contents and Liability Insurance

Tenant 1

I/We meet all of the following eligibility criteria

Rent Property Address

Number of bedrooms?

Property type?

Amount of contents cover required?

What is your current no claims discount for contents?

Select your contents excess

Policy Start Date

Contents and Liability Insurance

Telephone number

I would like to receive my documents by

Do you wish to specify a correspondence address?

Please read carefully the statements below

Have you read all the above statements?

Preferred Direct Debit Date

INSURANCE DECLARATION

FAIR PROCESSING NOTICE – USING YOUR PERSONAL INFORMATION

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