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Land insurance quote

To obtain an instant land insurance quote please complete the following form. If you need assistance completing this form, please contact us on 0800 1696137.

Policyholder Details
Title
First Name
Surname
Company Name (if applicable)
Contact Tel Number
E-Mail

Type of Land to be Insured
(select all that apply)
Development Site - an area of land that is subject to a future development
Moorland - open land usually with peaty soil covered with heather and bracken and moss
Private Road - regularly maintained private road
Residents Land - land which has had a dwelling erected upon it
Rough Country - large fields of hilly terrain or with scattered rocks
Undeveloped Pasture - undeveloped land with vegetation cover such as a field used for grazing
Woodland - land that is covered with trees and shrubs
Other - please select this and provide a description if you cannot find your type of land listed
Details of land if 'Other' selected above

Risk Details
Address of Land
Street (or nearest street)
Town
County
Post Code (or nearest post code)

Acreage of the site (round up to nearest whole acre)
Are there any watercourses or water features at or adjacent to the land
Are there any automatic gates or barriers on the site
Do the public have rights of access
Is there any childrens' play equipment on the land
Are there any non-residential buildings on the land

Cover
Date Cover Required From
Public Liability

Additional Information
Any Claims, Incidents or Losses
Additional details that have not
previously been asked and may
have a bearing on this risk
inc. details of any claims

Terms and Conditions
Do you agree with the above terms and conditions: Yes No

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