Home Insurance
If you have any questions with this form please telephone us during office hours on
2124 6262
so we can assist you.
Your Residence
Type of residence *
select
-- Select --
Flat
Penthouse
Maisonette
Terraced house
Semi-detached house
Detached house
Bungalow
Occupied by you as *
select
-- Select --
Your main residence
Your weekend, holiday or summer residence
What year was the property approximately built? *
Is your residence left unoccupied for more than 3 consecutive months?
Yes
No
Is your residence finished in every respect and all permanent aperatures installed?
Yes
No
Is your residence protected by a burglar alarm?
Yes
No
Do you have any other policies with Middlesea Insurance?
Yes
No