Proposer Details

Please tell us about the policyholder by answering the questions below.

How did you hear about us?

Title

Forename

Surname

Postcode Click Get Address

Address

Preferred contact number

Mobile contact number

Email address

Cover date

In order to get our cheapest price, we will perform a number of searches Including a credit check

Under the Consumer Insurance (Disclosure & Representation) Act 2012, it is your duty as a consumer to take reasonable care not to make a misrepresentation to an insurer. Misrepresentation to an insurer in certain circumstances could result in a claim being penalised or rejected. It is important that you ensure all statements you make on proposal forms, claim forms and other documents are full and accurate and we recommend you keep a copy of all correspondence in relation to the arrangement of your insurance. If you are in any doubt about any point in relation to your duty to take reasonable care, please contact us.

We would like to keep you informed by letter or by phone about our products, services and additional benefits that we believe may be of interest to you. If you do not want us or our partners to do this, please do not tick the box.