Home Insurance Quotation Request
Title
First Name
Surname
Address
County
Postcode
Telephone Number
Mobile Number
Email
Date of Birth
Marital Status
Main Occupation
About your property
Type of Property
Is your property listed?
Date built
Number of bedrooms
Is there any business use at the property?
Are there any trees within 10 metres of your property?
Do you have any refurbishment or building works planned or in progress?
The home you want to insure:
Is your main residence and only lived in by you and your family
Is built of brick or stone and roofed with slate or tiles
Is NOT showing any sign of or ever had any damage caused to it by subsidence, landslip or heave
Is NOT left unoccupied for a total of more than 60 days in a year
Is NOT a weekend/holiday or second home  
Is in a good state of repair
Is free from flooding and more than 200m from a watercourse or the sea
There is an area at the end of this form to add extra comments and details
About your property
Please provide information where you cannot agree to the previous statement.
If you need advice the please call us on 0844 272 5358, we are hear to help!
About your property
Security and Fire Protection
Do you have an alarm?
Do you have smoke detectors?
What security locks do you have on your front door?
What security locks do you have on your patio or french doors?
What security locks do you have on your back door?
What security locks do you have on your windows?
Claims
Claim 1
Claim 2
Claim 3
Claim 4
In the past 5 years have you:
Made a claim under any home insurance?
had any claims made against you whether or not insured?
(you can state up to 5 claims online)
Claim 5
Date of claim
Cost of claim
Description of claim
Date of claim
Cost of claim
Description of claim
Date of claim
Cost of claim
Description of claim
Date of claim
Cost of claim
Description of claim
Date of claim
Cost of claim
Description of claim
Buildings & contents cover
Main building
Contents to be covered in the home
Pedals cycles
Contents to be covered world wide
Jewellery and watches
Fine art & Antiques
Please use the space below for any special cover requirements or to list expensive items.
Getting the deal...!
Click here to upload an inventory
We guarantee to always quote our best premium.
However there is a huge market for home insurance and from time to time our best premium will not be good enough.
We do have the ability to match your current premium!
Complete the details below and if we cant smash your premium we will usually be able to match it less at least 5%.
Information opt out
Entrust Insurance would like to let you know about other relevant products and promotions available from us and our carefully chosen suppliers by post, text, telephone and email. If you would not like to receive this information please tick this box
Terms of Business
The FSA requires that you are presented with a copy of our Terms of Business. The explains how we deal with complaints and compensation and offer our advice and quotations. Please tick to say you’ve read our  Terms of Business
View our Terms of Business here
Please add any special requests and additional information here:
In order to use the premium matching offer cover must be like for like and we will need a copy of your renewal schedule.
Renewal premium
Insurer
Excess at renewal
IMPORTANT NOTICE
Submission of this form is to request a quotation only.
No insurance will be in place until confirmed by a representative of Entrust Insurance Services.