House Insurance Quick Quote

    Quote Form

    Please take 50 seconds to complete the following form to receive a tailored quotation for your house insurance.

    Required fields are marked with *

    Your Details

    • First Name *
    • Surname *
    •  
    • Date of Birth *
    • Telephone *
    •  
    • Occupation *
    • Mobile *
    •  
    • E-mail *
    •  
    •  

    Property Details

    • Property Type *
    • Address *
    •  
    • Your Property Is *
    •  
    • Year Built *
    • Town / City *
    •  
    • Years at Current Address
    • County *
    •  
    • Number of Bedrooms *
    • Heating System in Place:*
    •  
    • Buildings Cover Amount (€) *
    • Service Provider:*
    •  
    • Contents Cover Amount (€) *
    • Burglar Alarm:*
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    • Key operated locks on accessible windows
    • 3 or 5 lever mortice deadlocks on external doors
    •  
    • Flat Roof on Property?
    • Minimum of 2 smoke detectors
    •  
    • Is property Timber Framed

    Current Insurance Details (If Any)

    • Name of Current Insurance Company *
    • How many Years Claims Free do you have ? *
    •  
    • Current Premium
    • Any Claims/Losses in the past 6 Years ? *
    •  
    • Renewal Date *
    • How long are you insured on this property?
    •  

    Details of Claims (If Any)

    • Claim 1

    • Date
    • Type
    •  
    • Amount (€)
    •  
    •  
    • Claim 2

    • Date
    • Type
    •  
    • Amount (€)
    •  
    •  
    • Claim 3

    • Date
    • Type
    •  
    • Amount (€)
    •  
    •  
    • Claim 4

    • Date
    • Type
    •  
    • Amount (€)
    •  
    •  

    Other Details

    • Motor Insurance Renewal Date?
    • Where Did You Hear About CUsafe?