Personal Car Insurance

Whether you’re a young driver looking for your first policy, an experienced motorist with a great claims history or someone with expired driving bans or points on their licence, finding the right cover for your needs can often be confusing and time consuming. We will remove the confusion and take the time to find the best cover for you.

Third-party only – this is the minimum cover required by law and will only protect you for third-party liabilities – e.g. damage to another driver’s car in the event of an accident
Third-party, fire and theft – this basically the same as third-party, but it also insures your vehicle should it be stolen or damaged or lost in a fire
Fully comprehensive – fully comprehensive will cover you should your vehicle be lost to fire, stolen and, in the event of an accident, it will pay for repairs to your vehicle

We can also provide additional cover for Replacement Vehicle, Breakdown Recovery and Motor Legal Expenses.

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Please complete the details below as fully as possible.

Proposer details

* Title:

* Full name:

* Email address:

* Daytime tel no:

Home tel no:

Address at which the vehicle is normally kept:

Postcode:

Date of birth: D: M: Y:

Occupation:

Do you have a claims history (within 5 years)?: YesNo

Date: D: M: Y:

Details of loss:

Amount:

Do you have a convictions history (within last 5 years): YesNo

If you ticked yes, you must fill in the section below:

Date: D: M: Y:

Code:

Points (No):

Ban Mths:

Fine:

Vehicle details

Make:

Model:

Registration Number:(if known)

Year of registration:

Vehicle value:

Is business use required:

Fuel type:

Transmission: ManualAutomatic

Modifications / further information:

Security measures, if any:

The renewal/start date of the insurance:D: M: Y:

The purchase date of the vehicle:D: M: Y:

Additional driver details

Name of additional driver:

Date of birth: D: M: Y:

Cover & use

Policy Start Date :D: M: Y:

What cover is required?:

Voluntary excess required?: £100 Excess£150 Excess

Period of insurance:

Drivers

Please select which drivers need to be insured:

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