Tel: 01623 641 386     
Landlords Multiple Property Insurance
 
Midlands Insurance Services Logo


Main Menu



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)
Ownership Status:
Proposer's Correspondence Address:
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 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 or sheriff decrees?Yes     No
If yes, please provide details:
(i.e. date of bankruptcy/insolvency, amount of
bankruptcy/insolvency, date of discharge, 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? years
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 which
property that was affected, the date it
was affected and the amount of the damage:
Are any of the properties within 400
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
Can you confirm that all gas appliances are
inspected by a 'Gas Safe' engineer at least once a year?
Yes     No
If no, please provide details:
Are all residential properties let on a
minimum of a 6 month tenancy agreement?
Yes     No
If not, please provide details:
Are any of the properties sub-let or let
with more than one tenancy agreement?
(i.e. House Multiple Occupancy)
Yes     No
If yes, please provide details:
Cover Required
Level of cover required:  help
Is cover required for subsidence, heave or landslip?Yes     No   help
Is cover required for terrorism?Yes     No   help
Property excess required:
(Larger excess will reduce the premium)
  help
Property owners liability limit of indemnity:   help

Property 1.

Risk Address 1.
Address of property to be insured:
Postcode of property to be insured:
Risk Details
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help
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
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):   help
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:
Buildings
Buildings Sum Insured (£'s):   help
Loss of Rent
If cover is required for loss of rent,
please state the current rent receivable (£'s):
  help
(£'s per annum)
Landlords Contents
Landlords Contents (if required) (£'s):   help

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.)

Optional Legal Expenses Cover

Is £50,000 legal expenses cover required?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