Questionnaire

There are conditions, limitations, exclusions and excesses within the wording, a copy of which will be provided on request. You should keep a record (including copies of letters) of all the information supplied.

Proposer +
Please Note:: If you want to include additional policyholders please enter their details in the information box overleaf

Where buildings insurance is required state any Building Society, Bank or other financial institution that is providing you with a mortgage or loan on your property:

Sums Insured +

You must take reasonable steps to ensure that your sums insured are adequate at all times otherwise we do not have to pay a claim under this policy.

The default excess is €250, you may reduce this to €100 (this will increase your premium) or you can increase the excess which will reduce your premium.

In the event of a claim where the incident of loss or damage that falls for consideration is covered under more than one section of cover and you have chosen a different excess under that section, it is the highest applicable excess that will be deducted from the total settlement of any claim.

If we impose a compulsory increased excess you will not be entitled to a discount. You will be advised by your broker if this applies to your policy.

Fine Art is defined as: Individual items, collections and sets which are of artistic merit, historical value, novel, rare and/or unique including, antique and designer-made furniture, paintings, drawings, etchings, prints, photographs, tapestries, carpets, rugs, books and manuscripts, sculptures, ornaments, porcelain and glass, clocks, barometers, mechanical art and objects d’art, stamp and coin collections, wines, memorabilia and other collectables such as models and dolls.

Valuables are defined as: precious metals, gemstones, jewellery, watches, furs and guns which belong to you. Precious metals means gold, silver, and platinum, including gold and silver plate

Please specify any Fine Art & Antique Items over €15,000::

Please provide valuations or purchase reciepts of not more than 5 years old for all Fine Art & Antique specified items

Please provide valuations or purchase reciepts of not more than 5 years old for all Valuables specified items

In the event of a claim where the incident of loss or damage that falls for consideration is covered under more than one section of cover and you have chosen a different excess under that section, it is the highest applicable excess that will be deducted from the total settlement of any claim.

If we impose a compulsory increased excess you will not be entitled to a discount. You will be advised by your broker if this applies to your policy.

Date of Loss Brief Description of Loss/Damage Location Amount Status
Declaration +