Quotation Request Landowners Liability Insurance About About the Land Cover Declaration Cover Details Hidden Calculations Introducers About Please confirm that you will answer all these questions accurately, to the best of your knowledge and most importantly, honestly.Failure to do so could mean we don't pay a claim, amend the terms of your policy, or in the case of deliberate non-disclosure treat this policy as though it never existed. YesNo About You What is your name? -- Mr Mrs Miss Ms Dr Prof. Capt. Lord Lady Major Rev. Master Exec(s) of Mx What is your Date of Birth? 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 What is your correspondence address? UDPRN UPRN Organisation Line 1 Line 2 Town/City County Postcode Enter address manually or Enter address manually Use address lookup What is your email address?If you already have an account, please login at the top of the page. Email you will log in with this Forgot your password? Email enter again Password Password enter again What is your phone number?It is unlikely we will need to call you. But if we do, what is the best phone number to contact you on? I agree to Insuristic sending me occasional tailored emails on other relevant products, news, tips and exclusive offers. YesNo Land Ownership Who owns or is responsible for the land? Please Select A Private Individual Business Council Trust The Executor of the Estate (if in Probate) Charity or Consumer Group Other Who owns the land? What is the legal status of the business or organsation? Please Select Sole Trader Partnership Limited Company Limited Liability Partnership PLC Trust About the LandWhat type of land do you wish to cover Please Select Car Park Development Site Grazing Land, Moorland, Woodland or Pasture Land Private Road Rough Country Other What is the size of land (in Acres) that you wish to cover? Please Select Up to 5 Acres 5 - 10 Acres 10 - 20 Acres 20 - 45 Acres Over 45 Acres What is the address of the land to be insured?If a Postcode is not available, please enter one for a location nearby UDPRN UPRN Organisation Line 1 Line 2 Town/City County Postcode Enter address manually or Enter address manually Use address lookup Is the land used for any revenue generating purpose?Such as you rent it out to owners of animals or activity providers YesNo What is the land used for Are there any ponds, lakes, rivers or other water sources within the boundaries of the premises? YesNo Are there any public rights of way within the boundaries of the premises? YesNo Has the land suffered problems with vagrants, squatters or vandals in the last 5 years? YesNo Are there any buildings on the land? YesNo Is the building(s) derelict and/or awaiting demolition? YesNo Are the premises in a good state of repair, structurally sound and regularly inspected to ensure they continue to be so? YesNo CoverWhat is the name of the insured? The Insured Name should be the full names of the Person or Persons who own the land The Name of the Insured in Probate should be either: If there is a will: The Executors of the estate of 'Name of the Deceased' If there is no will: The Administrators of the estate of 'Name of the Deceased' The name of the organisation should be shown as:For a sole trader, the name should include your full name plus the trading name For a partnership, you should show the full names as well as the partnership name For a limited company, you should include the full limited company name Insured Name should be the full name of the Trust. How much Public Liability Insurance do you need? Please Select £1,000,000 £2,000,000 £5,000,000 When do you need the cover to start? 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 DeclarationHave there been any landowners liability claims associated with this land in the last 5 years? YesNo Please confirm if the insured or any principal, partner, director or shadow director in the business: Have been declared bankrupt or insolvent, or are currently subject to any bankruptcy or insolvency proceedings? YesNo Has the Proposer been bankrupt more than once? YesNo Has the bankruptcy been discharged? YesNo Was the Bankruptcy discharged within the last 3 years? YesNo Have been subject to an investigation or prosecuted by the Health and Safety Executive and have any notices been issued? YesNo Has ever been an Officer or a Director of an insolvent company? YesNo Has this happened more than once? YesNo Has been disqualified under the Company Directors Disqualification Act 1986? YesNo Have been convicted or charged with (but not yet tried), have any prosecution pending or given an official police caution in respect of any criminal offence or other offence other than a (road traffic) motoring offence or those considered spent by the Rehabilitation of Offenders Act YesNo Have had an insurance application refused or declined, an insurance cancelled or renewal refused, or any increased or special terms applied to any business insurance. YesNo Have any outstanding County Court Judgement(s) or Sheriff Court Decree(s) YesNo How many do they have in total? Please Select 1 2 3 4 5 or more Appear on any sanction prohibition or restriction under the United Nations resolutions or the trade or economic sanctions laws or regulations of the European Union, United Kingdom, or United States of America YesNo Been involved or associated with the management of any Company Partnership or Business which has ceased to trade following or as a result of the appointment of a receiver, liquidator, administrator or other insolvency Practitioner YesNo Been involved or associated with the management of any Company Partnership or Business with an administrator liquidator or a supervisor or nominee under a voluntary arrangement or any compromise or arrangement with creditors whether formal or informal YesNo Have you provided Insuristic with honest and accurate answers to all questions asked?I understand that if I have failed to do so, my cover may be limited, claims payments proportionately reduced or my policy rendered invalid. YesNo Have you provided Insuristic with a fair presentation of the risk and have taken care when answering any questions asked by ensuring that all the information provided is accurate and complete?A fair presentation is one which clearly discloses in a clear and accessible manner all material facts which I and any senior management within my business ought to know following a reasonable search of the business for this information. I understand that if I have failed to do so, my cover may be limited, claims payments proportionately reduced or my policy rendered invalid. YesNo Cover Details Total Premium (Net) £0.00 + IPT @ % £0.00 + Policy Fee £ £0.00 Total Premium £0.00 Total Commission £0.00 (Due From Broker) £0.00 Hidden CalculationsLimit of Liability £ Cancellations Cancellation Reasons Please Select Alternative product purchased Cover no longer required Cover overlapped with pre-existing cover Non Disclosure of Information Payment in Arrears Poor service/complaint Broker Poor service/complaint Claims Poor service/complaint Insurance Company Product too expensive/Uncompetitive Product unsuitable/incorrect coverage/misunderstood Product cancelled within cooling off period Product cancelled by underwriter Unacceptable Adjustment Unacceptable Terms and Conditions Other (administrative reason) Not known Producers Producer Name Producer Commission Percent Commission SchemeServe Agent ID Agent Email Agent Commission Percentage Agent Commission £ MGAM UMR Policy Number Prefix Policy Number Policy Wording Welcome Email Sent?Will only be sent for Direct cases YesNo Introducers Introducer 1 Introducer 1 Name Introducer 1 ID Introducer 1 Commission Percentage Introducer 1 Commission £ Introducer 2 Introducer 2 Name Introducer 2 ID Introducer 2 Commission Percentage Introducer 2 Commission £ Introducer 3 Introducer 3 Name Introducer 3 ID Introducer 3 Commission Percentage Introducer 3 Commission £