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 an alarm?
Yes
No
Do you have any other policies with Middlesea Insurance?
Yes
No