Please complete the enquiry form below and our experienced staff will contact you ASAP.

Our UK call centre is open from 9am to 8pm weekdays and weekends till 4pm.

YOUR PERSONAL DETAILS:

Title:
Full Name:
Address:
Post Code:
Date of Birth:
 (DD/MM/YEAR)
Contact Details:
 Work Tel: Mobile: email:
Marital Status:
Smoker:
Occupation:

DETAILS OF YOUR PROPERTY:

Type of Property:
What % of the roof is flat:
No of Bedrooms:
First time buyer:
Wall Construction:
Year home built:
Roof Construction:
No of occupants:
Adults
Ownership:
 
Children

Date of residency: (DD/MM/YEAR)
How many years No Claims Bonus (continuous insurance):
Have you suffered any claims in the last 5 years:

If yes, we need date/circumstances and costs below:

SECURITY:


5 Level mortice locks fitted on all external doors:
Key operated window locks on all accessible windows:
(If no please enter details below) *
Are you a member of neighbourhood watch scheme:
Do you have exterior security lighting:
Is the property fitted with an Alarm:
(If yes please selection which type of alarm)
Any smoke detectors in the home:


COVER DETAILS:

Building Sum Insured (£): Cover:
Contents Sum Insured (£): Cover:

Do you require any personal possessions covered outside the home:

(This will cover items such as jewellery; baggage etc anywhere in the UK or even World-Wide
but the single article limit must not exceed £1000)

Please confirm Limit of cover required away from home (£):
Would you like to specify any items in excess of £1000 away from home?

If yes please enter details:



Would you like Legal Expenses:
Do you have a premium you would like us to improve on: (£)


Just Insurance Travel Website
Just Insurance Agents Ltd., Victoria House, Sunderland. SR1 2QF | Telephone: 0800 2942969

Newton Lee Insurance Services Trading as Just Insurance Agents Ltd.
Authorised and Regulated by the Financial Services Authority (FSA)