Home Contents & Building Insurance
Tel: 01992 718666
 
To obtain a quote, please complete the following, and press the "Submit Request" button at the bottom of the form.We will contact you by telephone or email with a quote
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email Address
Confirm email Address
Title
First Name
Surname
House No./Name
Street
Town
County
Post Code
Country
Tel. Number - Day.
Tel Number - Evening
Occupation
Date of Birth
Where Did You See Us Advertised
Existing Customer (Any Product) YES NO 
Renewal Date of Current Insurance
How Long Have You Held Insurance of This Type 
Property Details:
  
House or Flat
If a House, is it Terraced, Semi-Detached or Detached
Number of Bedrooms
Property Rebuild Sum Insured £
Year Built
Is Property Free from Subsidence
Is Building Accidental Damage Cover Required
   
Contents Cover Required
Contents Replacement Sum Insured £
Accidental Damage to Contents
Specified Contents (Jewellery/Pictures) £
Is Personal Possesions Cover Required Outside the Home
Value of Personal Possesions to be Covered Outside Home £
Have you had a previous claim YES NO  

If YES, Detail any Previous Claims

(pressing 'enter' at the end of each line)
   
Declaration: I declare that the information I have given above is true and complete. I have not withheld any material facts (see IMPORTANT NOTES.) I agree that this proposal shall form the basis of the Contract between me and Shearwater Insurance.
Shearwater Insurance Services Ltd
Registered Office: 2 Bath Place, London, EC2A 3JJ. Registered in the UK Company No: 02701633