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Get a Land Insurance Quote

    PLEASE COMPLETE THE FORM BELOW TO RECEIVE YOUR QUOTE
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    Call us now on 01254 231 332

    Date Cover Required from?

    Current Insurance Held with?

    Current Insurance Premium?


    CUSTOMER DETAILS

    Contact Name*

    Telephone Number*

    Email Address*

    Correspondence Address

    Postcode


    PLEASE ENTER THE FULL NAME(S) AND ANY TRADING NAMES AS THEY SHOULD APPEAR ON POLICY DOCUMENTS

    Name of Insured

    What Is the Insured Status?

    Address of Plot of Land

    Postcode of Land

    If the Plot of Land Address Is the Same as the Correspondence Address, Is the Plot of Land on the Same Title as Your Home Residence?


    INTERESTED PARTIES

    Do You Need to Note the Interest of an Interested Party?

    If ‘Yes’, Please Provide Details Below


    LANDOWNERS’ LIABILITY

    Public Liability Limit of Indemnity

    Is Cover Required for Employers' Liability?

    If 'Yes', Please Enter the Number of Employees for the Following Types:

    Clerical or Non-Manual

    Manual Work (see definition below)

    Manual Work definition: Manual work consists of Coppice Work, Gardening, Guided Walks and Tours (excluding Foraging), Maintenance – No Heat, Woodwork or Chainsaw Use, Maintenance – Chainsaw Use, Maintenance – Woodwork, Rural Craft Work, Supervision of Educational Classes or Visits (including Foraging and Bushcraft), Woodworking, Sculpting and/or Tuition of Woodcraft

    Farming

    Maintenance – Heat Work

    Any Other Manual Work

    Are You or Your Company Exempt from Having an ERN?

    What Is Your Employer Reference Number (ERN)/Employer PAYE Reference?


    INFORMATION ABOUT THE LAND TO BE INSURED

    Number of Years You Have Owned the Land?

    Type of Land (Please Select the Land Type)

    If ‘Other’, Please Provide Details Below

    Size of Land (Please Select the Size of the Land in Acres)

    If You Selected 'Private Road' as a ‘Type of Land’, Is the Private Road in a Good State of Repair and Regularly Maintained?

    Is the Land Rented out?

    If ‘Yes’, Please Provide Details Below

    If the Land Is Let out to a Third Party to Use as Farmland, Do They Have Their Own Farming Insurance Policy in Place?

    Is the Land Being Used for Growing Crops for a Commercial Benefit?

    Do You Allow Neighbours to Use the Land to Let Their Animals Graze?

    Are There Any Public Footpaths and/or Rights of Way Situated on the Land?

    Are There Any Watercourses or Significant Water Features within the Land to Be Insured or Adjacent?

    Is the Land Used for any Boating, Fishing or the Mooring of Boats?

    Is or Was the Land to Be Insured Used or Ever Used, by Any Petrol Station, Chemical Works, Gas Works, Oil Refineries, Power Stations, Landfill, Waste Tip, Underground Mines, Quarrying or Any Other Industries of This Nature?

    If ‘Yes’, Please Provide Details Below

    Do You Allow Any of the Following as Commercial Activities?

    Extreme Sports (such as off-road BMX)

    Shooting

    Water Sports

    Do You Allow Camping on the Land?

    Does the Land Contain Any Playgrounds or Play Areas?

    Does the Land Have Any Perimeter Protection such as Walls, Gates or Fences?

    Do You Allow Events on the Land such as Shows, Car Boot Sales, Festivals or Similar?

    If Yes, Please Provide Details Below:


    BUILDINGS ON THE LAND

    Are There Any Buildings/Structures Situated on the Land?

    (Buildings/Structures are defined as anything constructed or erected with a fixed location on the ground, excluding fences, gates and boundary walls)


    IF 'Yes'

    Is the Landowners Liability to Extend to These Buildings?

    Are These Buildings Occupied or Unoccupied?

    If These Buildings are Unoccupied, are They Structurally Sound and in a Secure Area, not Accessible to the Public?

    Is Material Damage Cover Required for the Buildings?


    IF 'Yes'

    Buildings Reinstatement Sum to be Insured

    Do You Require Subsidence Cover?


    CLAIMS

    During the Last Five Years under Any Other Insurance Policy Made a Claim(s), Incurred a Loss, Damage or Liability whether Insured or not at Any Premises, Land or Any Other Location

    If Yes, Please Provide Further Details Including Dates, Incidents and Amounts Paid or Reserves Held Below


    ADDITIONAL INFORMATION

    Please Provide Any Further Information or Material Facts You Wish to Disclose Below


    DECLARATION

    You or any director or partner in any business, any partner in any partnership, any director of any company, or the company;
    either in any personal capacity, in the name of the business proposed or in respect of any other business in which any of you have ever had an interest have:

    - Never had a proposal for insurance declined, cancelled or refused?
    - Never had insurance cancelled mid-term, a renewal refused, increased or special terms or conditions imposed by an insurer?
    - Never been given an official police caution, convicted of, charged (but not yet tried) or have any prosecution pending for any offence (excluding any motoring convictions and any offences which are spent under the Rehabilitation of Offenders Act 1974)?
    - Never been the subject of or issued with a County Court Judgement (CCJ), money judgement or court decree and/or ever been cited in any unsatisfied court judgements (or the Scottish equivalent) or any other judgements or decrees in relation to debt?
    - Never been declared bankrupt or insolvent, the subject of an individual voluntary arrangement (IVA) or company voluntary arrangement (CVA) with creditors, voluntary liquidation, a winding up or administration order, or administrative receivership proceedings, bankruptcy or insolvency proceedings?
    - Never been disqualified from being a company director?
    - Never been censured by any regulatory or trade body or any action been taken against the company by the office of fair trading, consumer groups or the alike?
    - Never been served under any Health & Safety, Welfare, Environmental, Consumer Protection or Food Safety legislation or any other legislation, with any warnings, enforcement measures, prohibition notice, improvement orders, proceedings or criminal proceedings by any Health and Safety Executive, Environmental Health Office, Environment Agency, local or government authority or any other enforcement agency or authority?
    - Never been convicted of, charged (but not yet tried) with, officially cautioned or have any prosecution pending for a breach of any Health & Safety, Welfare, Environmental, Consumer Protection, Food Safety legislation or any other legislation?
    - Never been the subject of a recovery action by Customs and Excise or the Inland Revenue?

    Please Confirm If You Agree with the Declaration

    If You Do NOT Agree, Please Detail Why Below

    How Did You Hear About Us?