01623 650750

Opening Hours 9am-5pm Monday-Friday

01623 663105

Opening Hours 9am-5pm Monday-Friday

01623 663101

Opening Hours 9am-5pm Monday-Friday

claims@aips.co.uk 01623 663110

Opening Hours 9am-5pm Monday-Friday

High Net Worth insurance form

more information

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AIPS is a specialist UK home insurance broker offering very competitive prices for Standard Home Insurance as well as hard to insure risks.

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Step 1 - Personal Details

Title:
First Name:
Surname:
Date of Birth:
Occupation:
Enter details about a joint policyholder (if required)
Title:
First Name:
Surname:
Date of Birth:
Occupation:

Step 2 - General Details

Renewal Date / Cover date?
Renewal premium?
Where did you hear about us?

Step 3 Please indicate how we may contact you

Preffered method of contact?
Telephone number?
Email address?
Confirm Email

Step 4 Please enter details about the property to be insured

House Number / Name
Postcode
Approximate year property built?
Approximate year property purchased?
Is the property?
Type of property?
Construction of the exterior walls?
Construction of the roof?
Approximate percentage of any flat roof?
How many bedrooms?
Is the property a listed building?
Do you share your home with lodger(s)?

Step 5 Questions

Only answer the following if buildings cover is required
Rebuild Value of the property?
Accidental damage cover required for buildings?
Only ansrwer the following questions if contents cover is required
CONTENTS sum insured?
Accidental damage cover for contents?
VALUABLES INSIDE YOUR HOME: such as pictures, works of art, televisions and home computers with an individual value over £1,500. Please list with sums insured here:
UNSPECIFIED PERSONAL POSSESIONS AWAY FROM HOME: If required, please select a sum insured. Pedal cycles and money should be listed under Specified Items(s) below.
SPECIFIED ITEMS(S) TAKEN AWAY FROM HOME: Such as jewellery, watches and laptops with an individual value over £1,500. Pedal cycles or money. If required, list each item with a Sum Insured here:
Please answer the questions regarding security at the property
Are all external doors fitted with 5 lever mortice deadlocks or UPVC / aluminium doors fitted with a multi point locking system?
Are all accesible windows fitted with key locks?
Is there a professionally installed burglar alarm at the property, with an annual maintainance contract?
If yes, is the alarm connected to a monitoring station?

Step 6 Has the policyholder(s) or anyone living at the insured property

Any unspent criminal conviction(s) or pending prosecution(s)?
Ever been declared bankrupt or the subject or bankruptcy proceedings?
Ever had an insurance proposal declined, had a policy cancelled by an insurer, renewal refused or had special terms imposed?
Has the property or the neighbouring area ever flooded or in an area at risk of flooding?
Has the property ever been damaged by subsidence or ground heave, monitored for subsidence, showing any visible signs of cracking or been underpinned?
Are there any trees or shrubs over 10 metres tall within 10 metres of the property?
Have you made any claims against home insurance policy for this or any other property or has there been any incidents of damage or los, within the last 5 years?
If you have answered 'Yes' to any of the questions above, please give details here. For each claim within the last 5 years we need to know the Month/Year, type of claim and cost.

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