Land Insurance Quote Form

Please leave this field empty.

Date cover required from?

Current insurance held with?

Current insurance premium?

How did you hear about us?

—Please choose an option—AI OverviewChatGPTClaudeGeminiCoPilotMetaGoogle Web SearchGoogle Sponsored ResultGoogle AdYahoo Web SearchBing Web SearchOther Web SearchFacebookXLinked InRecommendationExisting clientWord of mouthAdvertisementOther

CUSTOMER DETAILS

Contact name*

Telephone number*

Email address*

Correspondence address

Postcode

Name of insured

(Please enter the full name(s) and any trading names as they should appear on policy documents)

What is the insured’s trading type?

—Please choose an option—IndividualSole TraderPartnershipLimited Liability Partnership (LLP)Limited CompanyNon-Limited CompanyPublic Limited Company (PLC)Charity OrganisationCommunity Interest Company – CICOther

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?

—Please choose an option—YesNoNot applicable

INTERESTED PARTIES

Do you need to note the interest of an interested party?

—Please choose an option—YesNo

LANDOWNERS’ LIABILITY

Public liability limit of indemnity

—Please choose an option—£1,000,000£2,000,000£5,000,000£10,000,000Over £10,000,000

Is cover required for employers' liability?

—Please choose an option—YesNo

Are you or your company exempt from having an ERN?

—Please choose an option—YesNoNot applicable

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?

—Please choose an option—Less than 1 year1 year2 years3 years4 years5 years or more

Type of land (please select the land type)

—Please choose an option—AllotmentArable landCar park (up to 50 spaces)Car park (up to 100 spaces)Car park (up to 150 spaces)Car park (up to 200 spaces)Car park (over 200 spaces)Development siteFishing lake (excluding boat hire)Fishing lake (including boat hire)Grazing landMoorlandWoodlandPrivate gardensPrivate roadRough countrySelf buildUndeveloped pasture landOther

Size of land (please select the size of the land in acres)

—Please choose an option—Up to 1 acreUp to 2 acresUp to 5 acresUp to 10 acresUp to 15 acresUp to 20 acresUp to 25 acresUp to 30 acresUp to 35 acresUp to 40 acresUp to 45 acresUp to 75 acresUp to 100 acresUp to 150 acresUp to 200 acresOver 200 acres

Is the land rented out?

—Please choose an option—YesNo

Is the land being used for growing crops for a commercial benefit?

—Please choose an option—YesNo

Do you allow neighbours to use the land to let their animals graze?

—Please choose an option—YesNo

Are there any public footpaths and/or rights of way situated on the land?

—Please choose an option—YesNo

Are there any watercourses or significant water features within the land to be insured or adjacent?

—Please choose an option—YesNo

Is the land used for any boating, fishing or the mooring of boats?

—Please choose an option—YesNo

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?

—Please choose an option—YesNo

Do you allow any of the following as commercial activities?

Do you allow camping on the land?

—Please choose an option—YesNo

Does the land contain any playgrounds or play areas?

—Please choose an option—YesNo

Does the land have any perimeter protection such as walls, gates or fences?

—Please choose an option—YesNo

Do you allow events on the land such as shows, car boot sales, festivals or similar?

—Please choose an option—YesNo

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)

—Please choose an option—YesNo

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

—Please choose an option—YesNo

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*

—Please choose an option—Yes - I agree with the declarationNo - I do NOT agree with the declaration

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