Household/Let Property Claim Form 1 Step 1 Section One - Policyholder Nameno-icon Date of Birthdate_range VAT RegisteredYesNo Emailemail Trading Titleno-icon Private Address0 / Is your private address the property insured?Select An OptionYesNo Address of Property Insured0 / Private Telno-icon Business Telno-icon Mobile Telno-icon What time is best to contact you?9am - 12pm12pm - 3pm3pm - 4.45pm Policy No.no-icon Brokerno-icon SchemeSelect An OptionHouseholdLet Property Have you had any previous claims with us or another company?Select An OptionYesNo If so, please provide details on the type of claim, insurer and final settlement amount0 / Please provide details of your contents insurer and policy number0 / Section Two - Details of When, Where and How Loss/Damage Occurred Incident Datedate_range Incident Time00010203040506070809101112000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859access_time Location of Incidentno-icon Has the leak been repaired?Select An OptionYesNo Who Discovered ittheir full nameno-icon Date Discovereddate_range Time Discovered000102030405060708091011121314151617181920212223000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859access_time State fully the damage and cause of the Loss/Damage and how it occurredplease provide a full explanation as to the cause and damage caused0 / Is your property secure? Is there standing water or dripping or leaking water?Select An OptionYesNo If so, what measures have you taken to stop this? Is the property uninhabitable? If so, is the kitchen/bathroom affected? Do you still have full utilities usage? Did the fire brigade attend?Select An OptionYesNo If so, please provide their details Did the police attend?Select An OptionYesNo Please provide the date the incident was reported to themdate_range Please provide the station the incident was reported to PC reference number Crime reference number Were the premises unoccupied at the time of the loss?Select An OptionYesNo If yes, when were they last occupied?no-icon If yes, had the central heating been drained down?Select An OptionN/AYesNo Were the premises furnished for normal occupation at the time of the loss?Select An OptionYesNo Were any refurbishments taking place at the property?Select An OptionYesNo Section Three - Damage - Details of claim Please upload your quotes herecloud_uploadUpload Please upload photographs of the damage together with size and dimensionscloud_uploadUpload Estimated full cost of repair to buildingsno-icon If you have not received a quote what is the estimated cost of repairno-icon PROPERTY CLAIM FORMONLY EMERGENCY WORK TO PREVENT FURTHER LOSS MAY BE UNDERTAKEN. UNDER NO CIRCUMSTANCES SHOULD FULL REPAIRS BE CARRIED OUT WITHOUT UNDERWRITERS PRIOR CONSENT Has emergency work been carried out (e.g. to protect the property/prevent further damage)Select An OptionYesNo Section Four - Nomination Do you wish to nominate another person to deal with the claim on your behalf?Select An OptionYesNo Nominee Nameno-icon Address0 / Contact Telephone Numberno-icon PROPERTY CLAIM FORMPlease be aware that this would include any settlements due unless you specifically state otherwise. Section Five - Additional Information Please provide any additional information which may be helpful to us in dealing with your claim.0 / Section Six - Notice Red Seal Property Ltd will act on behalf of insurers in handling your claim and in the absence of your advices to the contrary, will assume your informed consent to your claim being handled on this basis. Please note that insurers pass information to the claims and underwriting Exchange register, run by Insurance Database Services Ltd (IDS Ltd) The aim is to help us to check information provided and also to prevent fraudulent claims. When you tell us about an incident (such as fire, water damage or theft) which may or may not give rise to a claim, we will pass information relating to it to the register. In accessing claims made insurers may also undertake checks against publicly available information as necessary such as electoral roll, county court judgements, bankruptcy orders or repossessions. Some of the information which you give us about this claim may be passed to other insurance companies you tell us about. They will give us information about your policy with them, and we may ask them to pay a contribution to this claim. A contribution payment is normal practice where two or more policies cover the same thing. If another company contributes to your claim with us, it should not affect any no claims discounts you may have with them. Section Seven - Declaration Please read carefully before signing I hereby confirm that the above information is a true and accurate statement. Unless Red Seal Property Ltd hear from you to the contrary within the next 24 hours the above contained information will be deemed to be a true and accurate record of events. I declare that the above statements are true and correct to the best of my knowledge and belief. I hold no other policy in addition to this one indemnifying me in respect of this claim. I have not withheld from the Insurers any information with my knowledge connected with the loss and I agree to provide the Insurers with any further information or documentation as may be required. I hereby confirm that Red Seal Property Ltd have my authority to recover any outlays on my behalf for monies paid under this contract of insurance in relation to this event. I understand that any attempt to make a fraudulent claim may result in prosecution. Signature(s)of Policyholder(s)no-icon Dateagreeddate_range AgreementBy checking this box you agree to let us collect the above information entered by you in this form. We will use this data to handle your claim and contact you regarding it.By checking this box you have read and agree to our Privacy Policy Submit Form If you are having trouble submitting the form then please reload your page and try again. keyboard_arrow_leftPrevious Nextkeyboard_arrow_right
