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Home Name and Address - so that our advisors can locate your details in our database Postcode - it is important that you provide the correct postcode as this is a factor that insurers take in to consideration when calculating premium Contact Name - so that we know who to contact in the first instance Phone Number, Fax Number and Email - so that we can deliver your quote to you as quickly as possible CSCI Registration Code - please tell us the number as it appears on your CSCI Registration document. This will allow the insurers to verify your information and review your inspection reports Type of Home - we need to know the type of service users you are registered to provide a service for. Please state this as it appears on your CSCI registration document Length of Time in Business - so that the insurers can verify your professional experience as a service provider Type of Property/Construction Details/Age of Property - so that the insurers can assess the accuracy of your re-instatement valuation and adjust your premiums accordingly. Please tell us if your business is operated from a listed building Current Insurer - so that we can establish the terms of your current policy cover Renewal Date - so that we can meet your renewal deadline
Older People Personal Carers People with Mental Health Problems Children People with Learning Difficulties People with Physical Disabilities People with Sensory Loss Others
Buildings (reinstatement costs) - please estimate what it would cost to re-construct your facility to an equivalent specification. The figure estimated should represent the full cost of reinstatement of the premises including debris removal, site clearance, architects and other professional fees. The figure presented could vary considerably from the market value of the property Contents (new replacement value) - please estimate the cost to replace, with new, the contents of your facility not including residents possessions Residents Personal Effects - please estimate the cost to replace, as new, the personal effects of your residents Annual Revenue - please tell us the estimated total annual revenue of your facility. This figure should be the projected revenue for the forthcoming year. Annual Wage Roll - please estimate what the total annual wage bill of your facility is likely to be for the forthcoming year. Please include all professional nursing staff, carers, administration staff, catering staff, maintenance staff, drivers, directors and managers No of Registered Residents - please tell us the total number of residents you are authorised to care for according to your CSCI registration document
Public Liability (limit of indemnity) - please select your current limit of public liability by checking the appropriate box. If you wish to increase your cover for public liability you may choose an alternative. Public liability insurance will cover you against legal liability to pay compensation to third parties for accidental bodily injury or accidental damage to property arising in connection with your business Subsidence Cover - if you wish the insurer to include cover for damage to your building due to movement of a piece of land please check the 'Yes' box, if not please check the 'No' box. If you wish us to include subsidence cover your premium will increase. Normally a substantial excess is applied to this type of cover Special Glass - (eg. Ornamental or stained) - if you wish the insurer to include special glass cover please check the 'Yes' box, if not, please check the 'No' box. Terrorism Cover - if you wish the insurer to include terrorism cover please check the 'Yes' box, if not please check the 'No' box. Terrorism cover is not provided under the standard terms of your policy Domiciliary Cover - if you operate a domiciliary care service and wish to receive a quote to cover this activity please check the 'Yes' box, if not, please check the 'No' box. If you wish to receive a quote for domiciliary cover please tell us the total estimated wages for the forthcoming year for clerical staff and carers. Please also provide a forecast of your turnover for the same period
Claims - if you have made any claims over the last three years please check the 'Yes' box, if not, please check the 'No' box. If 'Yes' please provide details in the fields provided
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