Tel: 01623 641 386

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Minibus Insurance Quotation Form

For UK Customers Only

Please insert your details here and one of our minibus insurance advisers will contact you with a quotation shortly.

Please note that we are only able to provide a quote which is valid for up to 30 days and therefore can only provide a quotation if your renewal date or start date is within the next 30 days.

If you have any problems with completing this form, please phone us on 01623 641 386 for assistance. Regrettably, we are unable to provide quotes for minibuses based in Northern Ireland.

Proposers/Contact Details

Ownership Details
Please state who is the registered owner of the minibus: (if not the proposer)
If registered in a company or a charity name, please state the name of your company/charity:
Proposers Details
Status:
First Name:
Surname:
Address:
Postcode:
Daytime Telephone No.
E-Mail Address:
Insurance Details
Renewal date/date cover required:	(dd/mm/yyyy)
Current Insurer:
Current premium/best quote:	This may help us to get you a better quote
NB. Proposer must be the main driver
Proposers Occupation:
Employers Business:
Employment Status:
Date of Birth:
Marital Status:
How long have you lived in the UK (years)
Type of Licence:
Number of years licence held:

Vehicle Usage

Usage Required:
Please state the reason/ details of use for the vehicle: (e.g. private family use, private hire, charity use, etc.)
Public/Private hire users only
If used for private/public hire, please confirm number of years established:	years
If used for private/public hire, is the minibus fitted with a 2 way radio?	No Yes
Is the minibus plated?

Vehicle Details

Type of Vehicle (re-type, if not a minibus):
Number of seats in the vehicle:	(Including Drivers Seat)
Are all the seats forward facing?
Are seat belts fitted?
Value of the Vehicle (£'s):
Vehicle Make (i.e. Ford, Leyland Daf, etc.):
Vehicle Model (i.e. Transit, 400, etc.):
Engine Size (c.c.):
Fuel Type:
Year of Manufacture:
Registration Number (if available):
Postcode where vehicle is kept overnight: (re-type, if different from the above address)
Where is vehicle kept overnight:
Annual mileage driven in the vehicle:
Is the minibus fitted with an immobiliser?	No Yes
Has the vehicle been imported or is it left hand drive?
Has the vehicle been modified?
If yes, please provide details of the modifications:

Cover Details

Type of cover:
Is breakdown cover required?:	No Yes
Number of years No Claims Bonus:
If you hold No Claims Bonus, state the type of policy No Claims Bonus earnt on:
Is Protected No Claims Bonus required? (only available if you have at least 4 years no claims bonus)
Driving Details
Who will drive the vehicle?
Claims / Convictions / Disabilities
Have you or any other driver who will drive the vehicle had any accidents or claims in the last five years?
If yes, please provide details:	Name of driver: Date of claim: Whether at fault: Claim type(theft, accident, etc.): Cost of claim:Ł ----- Name of driver: Date of claim: Whether at fault: Claim type(theft, accident, etc.): Cost of claim:Ł ----- Name of driver: Date of claim: Whether at fault: Claim type(theft, accident, etc.): Cost of claim:Ł ----- Unfortunately, we are unable to provide a quotation if you are exceeding 3 claims. -----
Have you or any other driver who will drive the vehicle been convicted of any motor offence?
If yes, please provide details:	Name of driver: Date of conviction: Type of conviction: No. of points: Amount of fine:Ł Was there a driving ban: If yes, length of ban: ----- Name of driver: Date of conviction: Type of conviction: No. of points: Amount of fine:Ł Was there a driving ban: If yes, length of ban: ----- Name of driver: Date of conviction: Type of conviction: No. of points: Amount of fine:Ł Was there a driving ban: If yes, length of ban: ----- Unfortunately, we are unable to provide quotations for more than 3 driving convictions. -----
Do you or any other driver who will drive the vehicle have any disabilities?
If yes, please provide details:	Name of driver: Type of disability: Whether D.V.L.A. informed: If yes, when declared to D.V.L.A.: Licence restriction: ----- Name of driver: Type of disability: Whether D.V.L.A. informed: If yes, when declared to D.V.L.A.: Licence restriction: ----- Name of driver: Type of disability: Whether D.V.L.A. informed: If yes, when declared to D.V.L.A.: Licence restriction: -----

Details of Driver 2 (if applicable)

Status:
First Name:
Surname:
Their Primary Occupation:
Their Employers Business:
Date of Birth:
Marital status:
How long have they lived in the U.K.? (years)
Type of licence:
How long have they held their licence? (years)

Details of Driver 3 (if applicable)

Status:
First Name:
Surname:
Their Primary Occupation:
Their Employers Business:
Date of Birth:
Marital status:
How long have they lived in the U.K.? (years)
Type of licence:
How long have they held their licence? (years)

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 Minibus Quotation button to send your quotation details to us.