For a Thatched Home Insurance, or Listed Home Insurance quotation, please complete the following form. Please note that all quotations provided are subject to the completion of a satisfactory application form.

For more information regarding our policies please click here and for Terms of Business please click here.

Title*:
Forename*:
Surname*:
Email*:
Address*:
Town*:
County*:
Postcode*:
Tel (Home)*:
Tel (Work)
Date of Birth*:
Occupation:
Date Cover Required*:
What prompted you to visit our site?*	Please Select... Mailshot Personal Quote Letter Google Internet Other Recommendation
Property Type*:	Please Select... Main Residence Second Home Let
Construction*:	Please Select... Brick - Block - Stone Wattle and Daub Cob Clunch Lathe and Plaster Timber Clad Other
Is the construction of the property more than 50% timber?*	Yes No
Roof Construction*:	Please Select... Slate - Tile Thatch Metal
Have you had any claims in the last 5 years?*	Yes No
If yes, details:
Any history of flood or subsidence?*	Yes No
If yes, details:
Buildings Sum Insured:	£
Contents Sum Insured:	£
Possessions Sum Insured:	£(single articles over £1500)

Property type*:	Please Select... detached semi detached end terrace mid terrace
Type of roofing material used*:	Please Select... Water Reed/Norfolk Reed Combed Wheat/Devon Reed Long Straw Fibre Thatch Other
Depth of Thatch*:	Please Select... Less than 1m 1m - 2m Over 2m
How are the chimney(s) utilised*:	Central Heating Open Fires Solid Fuel Stoves Gas/Electric Appliance Chimney Blocked (Select all that apply)
Has the chimney been swept in the last 12 months?* Yes No
Is the chimney lined to the*:	Woodburner Open Fire None of Above (Select all that apply)
What height is the chimney above the ridge?*	Please Select... Less than 1m 1m - 1.8m Over 1.8m
Do you have spark arrestors?* Yes No
Are open fires or solid fuel stoves used?* Yes No
How far is the nearest Fire Brigade?*	Please Select... Less than 5 miles Between 5 and 10 miles Over 10 miles
Has the electrical wiring been subject to a periodic inspection report by a suitably qualified electrician within the last 10 years?* Yes No
Do you have a fire alarm linked to a monitoring system?* Yes No
Does the property have a 60 minute Fire barrier/Thatchbatts?* Yes No
Has the chimney(s) and/or Liner(s) been inspected by a qualified engineer in the last three years? Yes No

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