Multiple Property Insurance Quotation Form

For UK Customers Only

Please insert your details here and one of our business advisers will contact you shortly.

This form is designed for quotes for property owners who wish to insure multiple properties or portfolios of properties with the option to include property owners liability, loss of rent, glass, etc.

Please note that this online quote form can accommodate up to a maximum of 10 properties.

For assistance with the completion of this form or if you have more than 10 properties, please phone us on 01623 641 386 or email a list of your properties to quotes@midlandsinsurance.co.uk.

Proposer's Details

Owner(s) Of The Property
Proposer's Full Name(s): (enter sole trader's name or all partner's names if a partnership)
Limited Company Name: (only if a Ltd. company owns or leases the buildings)
Contact Name: (if different to proposer's name)
Ownership Status:
Proposer's Correspondence Address:
Correspondence Postcode:
Daytime Telephone No.
*E-Mail Address:
*Please note that your email address will only be used to provide you with your quote and not for any other marketing purposes.
Proposer's Details
Have you, or any other partner or director ever had a proposal refused or declined or ever had any insurance cancelled, renewal refused or had any special terms imposed?	Yes No
If yes, please provide details:
Have you, or any other partner or director ever been convicted or charged (but not yet tried) with any criminal offence?	Yes No
If yes, please provide details: (i.e. type of conviction(s), date of conviction(s), length of custodial sentence, and/or details of any fines imposed, etc.)
Have you, or any other partner or director ever been declared bankrupt or insolvent or had any county court judgements (CCJ's) or sheriff decrees?	Yes No
If yes, please provide details: (i.e. date of bankruptcy/insolvency/CCJ, amount of bankruptcy/insolvency/CCJ, date discharged/settled, etc.)
Have you ever been prosecuted or served a prohibition order or improvement order under any Health & Safety Legislation?	Yes No
If yes, please provide details:
Business Description / Years Trading
Business description:
No. of years operating as a property owner?	year(s)
General Risk Information
Are all of the properties to be insured all in a good state of repair and maintained?	Yes No
If no, please provide the address(es) of the properties in poor repair:
Are any of the properties to be insured showing any signs of or have they ever previously been affected by subsidence, heave or landslip?	Yes No
If yes, please provide details of which property that was affected, the date it was affected and the amount of the damage:
Have any of the properties to be insured ever been previously affected by flood damage?	Yes No
If yes, please provide details of the address of the affected property(s), the date it was affected, and the amount of the damage (£'s):
Please provide details of any flood preventation measures (if applicable) that have been applied to the property(s) since the flooding:
Are any of the properties within 250 metres of a water course, sea, river, canal, etc.?	Yes No
If yes, please confirm address of the property(s) and the proximity to the water
If residential properties form part/all of your portfolio, are all residential properties let on a minimum of a 6 month tenancy agreement?	Yes No
If not, please provide details: (i.e. address of property(s), minimum length of tenancy, type of tenant (e.g. asylum seeker, etc.))
Are any of the properties sub-let or let with more than one tenancy agreement? (i.e. House Multiple Occupancy (HMO))	Yes No
If yes, please provide details: (i.e. address of property(s), number of tenants, type of tenant (e.g. students, etc.))

Cover Required

Cover Required
Level of cover required:
Is cover required for subsidence, heave or landslip?	Yes No
Is cover required for terrorism?	Yes No
Property excess required: (Larger excess will reduce the premium)
Property owners liability limit of indemnity:

Property 1.

Risk Address 1.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 2.

Risk Address 2.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 3.

Risk Address 3.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 4.

Risk Address 4.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 5.

Risk Address 5.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 6.

Risk Address 6.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 7.

Risk Address 7.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 8.

Risk Address 8.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Unoccupancy / Renovation
Are any of the areas of the building unoccupied?	Yes No
What percentage of the building is unoccupied?
How long has the property been unoccupied?
Is the property undergoing any renovation or expected to undergo any renovation work in the next 12 months?	Yes No
If yes, please confirm the work being carried out: (e.g. redecoration work, kitchens, bathrooms, etc.)
Does the work include structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned?	Yes No
If yes, please provide details of the structural alterations:
Is planning permission required for the renovations?	Yes No
If yes, has planning permission been obtained?	Yes No
Please confirm the cost of the renovations:
How long is the renovation work going to take?
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 9.

Risk Address 9.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Are any of the areas of the building unoccupied or undergoing any renovation?	Yes No
If yes, please provide details:
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):
Additional Properties
Do you wish to add another property?	Yes No

Property 10.

Risk Address 10.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Date property purchased:
Number of storeys: (including any basement, loft or attic accommodation)
Approximately, what year was the property built?	(yyyy)
Is the property a listed building? (e.g. grade I, II, etc.)
Tenancy Details
Occupation/Business of Main Tenant(s): (please state if unoccupied)
Please state the tenancy of the occupant:
Are any of the areas of the building unoccupied or undergoing any renovation?	Yes No
If yes, please provide details:
Construction
Property details:
Property Type (if a residential property):
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Is there any flat roofing?	Yes No
Percentage flat roofing:	%
If any flat roofing, please state the type: (e.g. 'felt/bitumen on wood' or 'concrete flat roof')
Construction of Floors:
Heating
Method of Heating: (e.g. radiators - hot water, etc.)
Fuel Type: (e.g. gas, etc.)
Electrical
Does the property have a current IEE electrical certificate (i.e. within the last 5 years)?	Yes No
Buildings
Buildings Sum Insured (£'s):
Loss of Rent
If cover is required for loss of rent, please state the current rent receivable (£'s):	(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):

Claims Experience

Claims Experience
Have you suffered any loss or had any claims made against these or any other properties you own in the last 5 years?	Yes No
Please provide details of all claims: (i.e. address of property, date of claim, amount claimed, circumstances of the claim, etc.)	Property Address: Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Property Address: Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Property Address: Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Property Address: Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Property Address: Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Unfortunately, we will be unable to provide a quotation if you have had more than 5 claims.

Optional Legal Expenses Cover

Landlord's Legal Expenses (optional)
Is landlord's legal expenses cover required? (£50,000 cover for property disputes, repair & renovation disputes, health & safety prosecutions, tax protection, rent recovery, tenant eviction, etc.)	Yes No

Additional Information / Cover(s)

If there is any other information that you wish to disclose or if you have any additional cover requirements, please provide details:
You are required to make a fair presentation of the risk to insurers which means that you are required to disclose every material circumstance which you know or ought to know relating to the risk to be insured. Materially important information is any information that could influence an insurer's decision to accept your risk including the cost of your insurance. Failure to comply with the duty of fair presentation could mean that your policy is void or that insurers are not liable to pay all or part of your claim(s). By submitting this quotation you are confirming that there are no other material facts to disclose other than those shown above.
Details Of Current / Previous Policies

Cover Start Date / Renewal Date:
Current Annual Premium / Best Quotation:	This may help us to get you a better quote
Name of Current / Previous Insurer:	e.g. Aviva, AXA, Allianz, QBE, RSA, Zurich, etc.

Request Quotation

Disclosure
Please ensure that all the information you have provided is correct and that you have answered all the questions accurately then press the Request Insurance Quotation button to send your quotation details to us.

Estimated Quote Time: 1 to 72 hours