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Policyholder details:

All questions marked with * must be answered in full.

Is the policyholder an individual or a company/organisation?

Unfortunately we are unable to accept cover on this policy.

Main policyholder details:

Correspondence address:

Unfortunately we are unable to accept cover on this policy.
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Insurance Product Information Document (IPID) / Policy Wording

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Important Notice

The information you have provided in this submission contains statements upon which we will rely when deciding whether to accept this insurance and the terms on which it may be offered, including the amount of premium payable.

It is very important that the information is complete and accurate. If you are in any doubt at all regarding any of the answers given, you should ask us or your insurance broker.

If any of the information provided by you changes after you purchase your policy or during the period of your policy you must immediately provide us with details of the changes.

We act on a ‘non-advised’ basis which means that we will offer you information about the significant features, benefits, limitations and exclusions of a particular insurance policy(ies), but it is for you to decide by assessing the features, benefits and conditions which of these best suits your requirements. When acting on a ‘non-advised’ basis, we act as Agent of the Insurer (that is to say, we represent the insurer).

This insurance is Underwritten by Royal & Sun Alliance Ltd. They are authorised and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.


To the best of my/our knowledge and belief all statements and information provided in connection with this insurance, either orally, electronically or in writing, are true. I/we understand that non-disclosure or misrepresentation of any of the answers given may entitle underwriters to:-

  • cancel my/our policy and refuse to pay any claim, or
  • not pay any claim in full, or
  • revise the premium and/or change any excess, or
  • revise the extent of cover or terms of the insurance.