esure About you Your home Your cover Your quote About you Welcome to esure. We offer buildings and/ or contents insurance. You can choose the cover you need at the end of the quote. Title Please select Mr Mrs Miss Ms Dr Reverend Sir Lady Dame Lord Rt. Honourable Professor First name Surname Gender Male Female Date of birth / / Marital status Please Select Married/Civil Partnership Single Living with Partner Widowed Divorced Occupation Main phone number Additional phone number Email address Retype email address Please enter the postcode of the address to be insured Are you a First time buyer? Yes No Cover start date / / Has the property for which insurance is proposed ever been damaged by flood from an outside source? Yes No Has the property for which insurance is proposed ever suffered from, or shown signs of, significant cracking, Subsidence, Heave or Landslip, or undergone any underpinning? Yes No Has anyone living permanently at the property made any home claim(s) for loss or damage or had any claim(s) made against them in the last 3 years? Please Select None 1 or more Claims - Burglary, Flood or Subsidence 1 Claim - Other 1 Contents Claim and 1 Building Claim More Than 2 Claims 2 Building Claims 2 Content Claims I would like to add a joint policy holder Yes No What prompted your visit? Please select Directory advert eg Yellow Pages email I am an existing esure customer Internet - BeatthatQuote Internet - CompareTheMarket Internet - Confused Internet - Gocompare Internet - Moneysupermarket Internet - Tesco Compare Internet - Other price comp. site Internet - Online banner advert Internet - Search engine eg Google ITV Weather sponsorship Letter to me/my partner Unaddressed letter/leaflet by post Magazine/Newspaper advert Poster Radio advert Recommended by friends/family Story in newspaper/radio/TV/online TV advert - daytime TV advert - evening Please read the following statements, carefully: We are able to provide you with a quote if you have exchanged contracts, have an agreed completion date and will move in within the next 30 days. The home for which insurance is proposed: is my main residence is built of brick, stone or concrete has a roof built of slate, tile, asphalt or concrete is self contained having its own separate lockable front door is occupied solely by me, my family permanently living with me, or any joint named policyholder as permanent residence is used as a private residence with no business use (other than clerical use with no business visitors) is in a good state of repair and will be maintained in this state is not occupied as a holiday home is not regularly unoccupied throughout the night is not unoccupied for a period in excess of 30 consecutive days I or any member of my family, civil partner, cohabitee or any joint named policyholder living permanently with me in the home, have not: had home insurance cancelled, refused or renewal refused been asked to pay an increased premium (other than normal rating increases) or asked to accept any special conditions or had any special terms imposed been convicted of any criminal offence (other than motoring convictions) or have any prosecution or police enquiry pending (any convictions spent under the Rehabilitation of Offenders Act 1974 do not need to be disclosed). (click here to confirm if you need to disclose) received a police caution in connection with an insurance policy/claim I confirm I have read and agreed to all of the above statements. I understand that if any of the statements do not accurately reflect my, members of my family, civil partner, cohabitee or any joint named policyholder’s circumstances, it could result my claim being reduced, rejected, additional terms applied or my policy voided. YesNo Your quote is issued subject to status. If you choose to buy, we may perform additional checks on you. To prevent and detect crime we may share the information provided to us with other organisations. Your personal information is used to provide you with a quotation and a policy. We would also like to use cookies to store information on your computer, to improve our website. One of the cookies we use is essential for parts of the site to operate and has already been set. You may delete and block all cookies from this site, but parts of the site will not work. For full details of how we use your information, and for more details about the cookies we use, please read the Privacy Notice section. Keeping you informed As a valued customer of esure Services Limited (trading as esure), we would like to keep you informed of our services and products. From time to time we may contact you by email, SMS, post, phone and through digital channels with quote reminders, special offers and other marketing messages we think may be relevant to you. Please see our Privacy Notice which explains why and how we process and use your data, and why it is in our legitimate interest to send you these messages. If you would prefer not to receive messages from us, you can unsubscribe here. 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