MAKING THE COMPLEX SIMPLE
A tailored Insurance solution
As Brokers, we have a wide range of insurance package options available, but before we can help, it's best we know what your broad overall needs will be
Please select from the types of insurance policies relevant to you
Properties you personally occupy as a Home/ Weekender
1
2
1 is , 2 is
How many members of your home are there?
1
2
3
4
5
1 is , 5 is
Properties you lease out as a Landlord
0
1
2
3
4
5
0 is , 5 is
Are any of the above short-term let?
Yes
No
Number of vehicles in your household
0
1
2
3
4
5
0 is , 5 is
Number of drivers of the above vehicle/s
1
2
3
4
5
1 is , 5 is
Any boats/ pleasurecraft?
1
2
3
1 is , 3 is
Do you have a business or are you self-employed?
Yes
No
In which of the months do your various policies fall due?
January
February
March
April
May
June
July
August
September
October
November
December
Choose as many as apply to you:
I want to make sure I have the best coverage
I want to make sure I have moderate coverage
I want to make sure I have limited coverage
Help me understand available levels of cover
Consolidate all my policies together; one point of contact
I want to pay all my policies in 1 instalment per month
Interested in protecting my family against cyber and online scams
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Lastly, your details so we can get in touch:
Name
First Name
Last Name
Email
example@example.com
Best Contact Number
-
Area Code
Phone Number
Best time to call
Before 9 AM
Between 9 AM - 5 PM
After 5 PM
Lead ID
Thanks, we look forward to getting in touch with you!
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