Household Get a Quote Form

Name*

First NameLast Name
Email:*
Address:
Are you an existing client?*

ΝοYes - please give details (e.g. policy number, ID, account)
Phone Number*

Area CodePhone Number
Please choose the insurance product of your interest:*
Details about the property to be insured:
Address*
District*
Postal Code*
Year of Construction:*
Year of Renovation (if any):
Residence Type*

Ground Floor DwellingTwo storied DwellingThree storied DwellingGround floor flatFlat on the first floorFlat on the second floorFlat on the third floorFlat on the fourth floorFlat on the fifth floorFlat on the sixth floorOther (Please state the number of floors)
Residence Use*

Private Use (Permanent Residence)Private Use (Holiday Residence)For rent on an annual basisFor rent for tourist purposes
Construction Type*

Conventional ConstructionConstruction with MudbrickMetallic ConstructionWooden ConstructionMixed Construction
Wall construction*

BricksConcretePlasterboardStoneWoodOther ( Please provide details)
Roof construction*

Light ConcreteReinforced ConcreteWoodTilesZinc Corrugated SheetsOther (Please provide details)
Other Information

Swimming PoolFire PlaceBasement
Plumbing Installation*

ExternalInternal (Not renovated)Internal (Please state the year of renovatation)
Is there any profession, business or trade carried in or around the building?*

NoYes
Will the property be left unoccupied for any period given in the options below?*
Protection Measures

Fire Detection System3m Firewall ZoneFire ExtinguishersWater DrainsAutomatic Water Drain PumpCCTV SystemAntitheft SystemSafeOther (Please provide details)
Please state if there was any claim during the last 5 years:*

NoYes
Please provide details of previous claim/s:

Sums Insured*

	Sum Insured
Building
Contents (excluding valuables)
Valuables
Outdoor Areas (Kiosks)
Outdoor Areas (Pergolas)
Outdoor Areas (Tents)
Outdoor Areas (Swimming Pool Cover)
Items in the open (Contents in the Outdoor Areas)
Items in the open (Photovoltaic Units)
Items in the open (Security Cameras and Alarm Systems)

Important Notes:

1. Please note that this form is for quotation purposes only. If you wish to proceed with a contractual agreement you will be required to submit a proposal form. 2. Our quotation will be based on the information you have submitted, therefore, any alterations and/or misleading information, will cause a revision to the quotation accordingly. 3. We have collected only personal data you have voluntarily provided to us and which are processed solely for the purpose of risk assessment and preparation of this quotation.Where additional information is sought, you will be informed at the time of the data collection. If we do not conclude with a contract any personal data collected will be destroyed immediately. However, in case that you choose us for your policy, we are obliged by law to retain your personal data for a period of at least 13 (thirteen) years after termination.
Should be Empty:

Details about the property to be insured:

Important Notes: