VAN
INSURANCE

VAN INSURANCE QUOTATION

Before proceeding with this quote, please note that currently we CANNOT offer insurance quotes for sexual offences involving minors (including illegal download/images)

PolicyHolder Details

Is policy in a company name or an individuals?
 

Main Driver

Title
 
Forenames
Surname
Address
 
 
Town / City
County
 
Postcode
 
Is the vehicle parked at this address overnight?
 
Contact Telephone Number
Alternative Telephone Number
Email Address
Sex
   
Date of Birth
e.g. dd/mm/yyyy
 
Occupation
Type of Business
e.g. Construction Industry, Education, etc.
Employment Status
 
Marital Status
 
Are you a home owner?
 
Type of Licence
 
How long have you held a licence?
 Years    Months
Have you ever held van insurance before?
 
Previous / current insurer

Renewal date/ date cover to start
Will the policyholder be the MAIN driver of the vehicle?
 
How many ACCIDENTS, CLAIMS or LOSSES regardless of blame has this driver had in last 5 years?
(whether insured or not)
 
How many MOTORING CONVICTIONS has this driver had in last 5 years?
(including any pending prosecutions)
 
How many NON-MOTORING/ CRIMINAL CONVICTIONS does this driver have?
(you do not need to disclose convictions deemed as spent under The Rehabilitation of Offenders Act 1974)
 
Do you, or any other person who may drive, suffer from any mental or physical disability, infirmity, illness or handicap?
 
Have you ever had insurance cancelled, renewal declined or special terms imposed?
 
Have you ever had a CCJ registered against you, been declared bankrupt or insolvent, or been a director of a company which went into liquidation, receivership or has been the subject of an administration order?
 

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