Private Dwelling Proposal Form Step 1 of 4 25% Personal DetailsName* Postal Address*Telephone* Email* Occupation status*---EmployedSelf-employedHousehold dutiesUnemployedStudentIdentity Card No* Present Insurer Period of insuranceFrom:* DD slash MM slash YYYY To:* DD slash MM slash YYYY Property DetailsType of Dwelling*----DetachedSemi-detachedFlatYear Dwelling Build* Option 1. Is the dwelling build of bricks and concrete? Option 2. Is there a basement and/or storeroom at the insures premises? Option 3. Have you ever suffered loss from the event you wish to insure? If yes, please give details Buildings and ContentsBuilding (Sum Insured) Untitled Option 1. Would you like Reinstatement value-based Insurance? Option 2. Is there a swimming pool in your dwelling? Option 3. Is there any other person having financial interest in the property; If yes, please give detailsContents (Sum Insured) Option 1. Would you like Reinstatement value-based Insurance? Option 2. Does the value of articles of precious metal, or other precious articles such as jewellery, furs, carpets, paintings or other works of art etc. exceed one-third of the Sum Insured on contents? If yes, please give details Please give details of any article or any collection of articles, which exceeds 5% of the Sum Insured on Contents? PLEASE SPECIFY WHETHER YOU WISH COVER FOR THE FOLLOWING RISKSFIRE LIGHTING EARTHQUAKE OR VOLCANIC ERUPTION EXPLOSION RIOT & STRIKE MALICIOUS DAMAGE AIRCRAFT & AERIAL DEVICES IMPACT STORM, TEMPEST & FLOOD BURSTING OR OVERFLOWING OF PIPES ETC THEFT ACCOMPANIED BY VIOLENT ENTRY THEFT NOT ACCOMPANIED BY VIOLENT ENTRY Extensions for Buildings and ContentsRadio and television aerials or solar heaters against Storm and Tempest damage Sum insured Intemnity for Loss of Rent (maximun 2 years) Sum Insured Express Consent in relation to the Processing of personal dataFor Data Protection Company Policy Click Here. * I have read the Data Protection Company Policy posted on this website I herewith provide Royal Insurance Company Ltd (and any successors and assignees thereof), my express and unconditional consent regarding the processing and creation of data records in electronic and physical form, of all my relevant personal data, that may include sensitive data which I have declared and submitted
