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Fair Processing Notice
 

Please answer questions accurately, honestly and to the best of your knowledge and belief, as otherwise it could result in claims under a future policy being declined.

We use personal information which you supply to us or, where applicable, to your insurance broker, for underwriting, policy administration, claims management and other insurance purposes, as further described in our Master Privacy Policy, available here: https://www.chubb.com/uk-en/footer/privacy-policy.html.

You can ask us for a paper copy of the Privacy Policy at any time, by contacting us at dataprotectionoffice.europe@chubb.com.


Personal Details:

Mr

Mrs

Ms

Miss

Sir

Dr

Professor

Lord

Lady

Please select an option from the drop down list
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Are you a resident of UK, Isle of Man, Channel Islands?
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License Type
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Have you or anyone living with you been refused insurance or had a policy cancelled?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
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Home details 

Is the address you wish to insure the same as the correspondence address?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
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Is the property you wish to insure your main home?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
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Does the property have a security alarm?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
Does the property have a fire alarm?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
Does the property have CCTV?:
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
Does the property have any water leak detection devices?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:

Buildings cover

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Do you have any Outbuildings?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
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Contents cover

the minimum sum insured is £150k

Valuable articles 

What is the estimated total value of the following: 

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Do you have a safe?
Complete this section and click submit to notify Chubb directly of system impairment. Systems Impaired:
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Motor Details 

Driver information- Please fill out each of the named drivers on the policy 

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License Type
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License Type
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License Type
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License Type
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Do you have or any driver have any unspent road traffic convictions or any pending motor prosecutions?
This field is required
Have you or any driver had a TT99 disqualification (totting up) within the last 5 years
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Have you or any drive ever been refused insurance or had a policy cancelled?
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Do you or any driver have Any Criminal Convictions, Prosecutions Pending or history of any bankruptcy?
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Vehicle and Driver mapping:

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Is the vehicle parked at home address?
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Overnight Parking 

If garaged is the garage alarmed?
This field is required
Is the parking below ground floor level?
This field is required
Does your property have electronic gates
This field is required


Annual Mileage:

Is this your everyday vehicle?
This field is required
This field is required