Step 1 of 5 - STEP 1
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What's the legal status of the business?
*
Sole Trader
Partnership
Limited Company
Please give us the name of the person who proposes this insurance
*
Mr
Mrs
Miss
Ms
Dr
Name
First
Last
What's the name of the business?
*
This could just be your trading name e.g. Len's Motor Repairs
How many years has the business been established?
*
New Venture
1
2
3
4+
How many years experience does the proposer have in the Motor Trade sector?
*
0 - 1
1
2
3+
Please estimate the number of vehicles sold/handled in any one year
*
0 - 5
5-10
10 - 20
20 +
What's the annual turnover of the business likely to be?
*
Turnover is the total value of sales generated by your business.
0 - £5K
£5k - £10K
£10k - £20K
£20k +
Please tell us about the Trade occupations - please select all that apply
*
Body Repairs / Spraying
Breakdown Recovery
Collection & Delivery
Vehicle Sales
Vehicle Importing
Mechanical Repair
Scrap Dealing
What percentage of the business is Body Repairs / Spraying?
What percentage of the business is Breakdown Recovery?
What percentage of the business is Collection & Delivery?
What percentage of the business is Vehicle Sales?
What percentage of the business is Vehicle Importing?
What percentage of the business is Mechanical Repair?
What percentage of the business is Scrap Dealing?
Total Business Percentage
Business Percentage Number
Your percentage involvement must add up to no more than 100 it's currently over!
Your percentage involvement must add up to 100 and is current under!
Which of the following vehicles are dealt/ handled?
*
You can select more than one
Private Cars / Saloons
Commercial Vehicles
Sports / High Performance
Classic / American
Imports
Motor Cycles
What percentage is Private Cars / Saloons?
What percentage is Commercial Vehicles?
What percentage is Sports / High Performance?
What percentage is Classic / American?
What percentage of vehicles are Imports?
What percentage is Motor Cycles?
Total Percentage Vehicles
Vehicles Percentage Hidden Value
Your percentage vehicles must add up to no more than 100 it's currently over!
Your percentage vehicles must add up to 100 and is current under!
Where does the business trade from?
*
Home / Mobile
Workshop
Lockup
Forecourt
Yard
Type the proposers home postcode or street to find your address
*
We'll look up your address automatically
ZIP / Postal Code
Home Address
*
Street Address
Address Line 2
Town / City
Postcode
Premises Address
*
Type the postcode or street to find the premises address and we'll look up the address automatically
ZIP / Postal Code
Premises Address
*
Street Address
Address Line 2
Town / City
Postcode
Including the proposer, please add persons that require cover to drive
Name
Relationship
Date of Birth
Edit
Delete
There are no
drivers.
Add driver
When would you need the policy to start?
*
Today
Tomorrow
Other
Cover start date
*
Day
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Year
2020
2019
What cover is required?
*
Comprehensive
Third Party Fire & Theft
Third Party Only
How many years no claims bonus does the proposer have?
*
0
1
2
3
4
5
6
7
What type of policy does the NCB come from?
*
Motor Trade
Private Car
Commercial
Company Letter
VEHICLES TRADED
What is the max value for a single customer's vehicle in your possession?
*
£2.5K
£5K
£7.5K
£10K
£12.5K
£15K
£20K
£25K
£30K
£40K
£50K
£50K+
What is the max value for any single vehicle for sale?
*
£2.5K
£5K
£7.5K
£10K
£12.5K
£15K
£20K
£25K
£30K
£40K
Where do you advertise your vehicles for sale?
Auto Trader
Ebay
Facebook
Gumtree
Other
You selected 'Other' tell us all ways you advertise vehicles for sale
Do you own, or use a recovery vehicle?
*
Please note unless you purchase Goods in Transit cover, vehicles on the back of a recovery truck are covered Third Part Only.
No
Yes - less than 3.5 ton
Yes - less than 7.5 ton
Yes - greater than 7.5 ton
Do you require demonstration cover?
*
(not including motorcycles)
Yes
No
Are vehicles owned, whether or not for sale, any of the following:
Please select if any vehicles owned, whether or not for sale, are any of the following:
*
Sports, high performance
Modified, customised, altered in any way
Left hand drive
Fitted with more than 6 passenger seats
Transporter carrying more than 2 vehicles
Adapted for disability
Kit vehicle
Has a fiberglass body shell
American or Canadian
Motorcycles, Quads or Trikes
Three wheeled vehicles
Classic, vintage or collectors vehicles
Imported (other than by the manufacturer)
None of the above
Please provide details:
This could be the registration number, make model, details of modifications.
MOTORCYCLE COVER
Does any driver require cover to ride motorcycles?
*
Yes
No
Does involvement in motorcycles constitute more than 25% of the business activities?
*
Yes
No
What is the max value for any single motorcycle ridden?
*
upto £2.5K
£5K
£7.5K
£10K
£12.5K
£15K
£20K
£25K
£30K
£40K
What is the max engine size (CC) for any motorcycle ridden?
*
200cc
500cc
600cc
No Limit
Superbikes
How many personal motorcycles are required to be covered?
*
1
2
3
4+
In years, what is the maximum age of any motorcycle covered?
*
1
2
3
4
5
6
What is the maximum number of motorcycles in your possession at any one time?
*
1
2
3
4
5
6
Do you require demonstration cover for motorcycles?
*
Yes
No
DECLARATIONS
Neither I nor any named driver has ever been refused insurance or had a policy cancelled or void, renewal declined or terms imposed
*
I agree
I do not agree
Neither I nor any named driver will carry goods of an explosive, hazardous or dangerous nature
*
I agree
I do not agree
I agree that neither I nor any named driver has ever been declared bankrupt, insolvent or been disqualified from being a company director
*
I agree
I do not agree
Neither I nor any named driver has ever been involved in any company within 6 months of it going into receivership or insolvency
*
I agree
I do not agree
Neither I nor any named driver has ever been the subject of any County Court Judgement (CCJ) or Sheriff Court Decree.
*
I agree
I do not agree
I agree that to the best of my knowledge and belief, all information given is true and complete, and I understand that Plan Insurance Brokers will rely on the information to accept the risk and calculate pricing.
*
I agree
I do not agree
I understand non-disclosure or misrepresentation of any information may render an insurance policy void
*
I agree
I do not agree
CONTACT INFORMATION
Contact email address
*
Mobile phone number
*
Please enter a valid phone number.
Landline number
I AGREE I AM HAPPY TO RECEIVE OTHER MARKETING MATERIAL BY EMAIL AND SMS INCLUDING THE PLAN INSURANCE BROKERS NEWSLETTER (YOU CAN OPT-OUT OF THESE MESSAGES AT ANY TIME)
*
I agree
I do not agree
CoverStartDate
HomeAddressCombined
PremisesAddress
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Terms of Business
and
Privacy Policy
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Title
*
Mr
Mrs
Miss
Ms
Dr
Name
*
First
Last
Relationship
*
Who are we adding to drive?
Proposer / Main Driver (you)
Spouse
Business Partner
Employee
Please provide your business partner's address
*
Type the postcode or street and we'll look up their address automatically.
ZIP / Postal Code
Business Partners Address
*
Street Address
Address Line 2
Town / City
Postcode
Date of Birth
*
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Year
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1961
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1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
How long have you been a UK resident?
*
Since Birth
5 Years +
Less than 5 Years
When did you become a permanent resident in the UK?
*
Day
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12
Year
2014
2015
2016
2017
2018
2019
How long have you held your driving licence for?
*
1
2
3
4
5+
Is motor trade business use required?
*
Yes
No
Is social use required?
*
Yes
No
Have you got a secondary occupation?
*
Yes
No
What is your secondary occupation?
*
What's your spouse's occupation?
*
Does this driver have any motoring convictions in the last 5 years?
*
Including disqualifications, prosecutions pending, police enquiries outstanding and fixed penalty offences.
Yes
No
Conviction code
*
Including convictions, endorsements, fixed penalties, bans or points in the last 5 years? This list shows the most common.
Please choose the conviction code
CU80 Using a mobile phone while driving a motor vehicle
SP30 Exceeding statutory speed limit on a public road
SP50 Exceeding speed limit on a motorway
IN10 Using a vehicle uninsured against third party risks
TS10 Failing to comply with traffic light signals
AC10 Failing to stop and/or give particulars after an accident
AC20 Failing to report an accident within 24 hours
AC30 Undefined accident offence
BA10 Driving while disqualified
BA20 Driving while disqualified by reason of age
BA30 Attempting to drive while disqualified
CD10 Driving without due care and attention
CD20 Driving without reasonable consideration for other road users
CD30 Driving without due care and attention or without reasonable consideration for other road users
CD40 Causing death by careless driving when unfit through drink
CD50 Causing death by careless driving when unfit through drugs
CD60 Causing death by careless driving with alcohol level above the limit
CD70 Causing death by careless driving then failing to supply a specimen for analysis
CD80 Causing death by careless, or inconsiderate, driving
CU10 Using a vehicle with defective brakes
CU20 Causing or likely to cause danger by reason of use of unsuitable vehicle or using a vehicle with parts or accessories (excluding brakes, steering or tyres) in a dangerous condition
CU30 Using a vehicle with defective tyres
CU40 Using a vehicle with defective steering
CU50 Causing or likely to cause danger by reason of load of passengers
CU60 Undefined failure to comply with Construction and Use regulations
CU80 Using a mobile phone while driving a motor vehicle
DD10 Driving in a dangerous manner
DD20 Driving at dangerous speed
DD30 Reckless driving
DD40 Driving in a dangerous manner, at a dangerous speed or recklessly
DD50 Causing death by dangerous driving
DD60 Culpable homicide while driving a vehicle
DD70 Causing death by reckless driving
DD80 Causing death by dangerous driving
DG10 Driving or attempting to drive with drug level above specified limit
DG40 In charge of a vehicle whilst drug level above specified limit
DG60 Causing death by careless driving with drug level above the limit
DR10 Driving or attempting to drive with blood alcohol level above limit
DR20 Driving or attempting to drive while unfit through drink or drugs
DR30 Driving or attempting to drive then refusing to supply a specimen or blood or urine for laboratory testing
DR40 In charge of a vehicle while blood alcohol level above limit
DR50 In charge of a vehicle while unfit through drink or drugs
DR60 In charge of a vehicle then refusing to supply a specimen of blood or urine for laboratory testing
DR70 Failure to supply specimen for breath test
DR80 Driving or attempting to drive when unfit through drugs
DR90 In charge of a vehicle when unfit through drugs
E001 No Driving licence - driving while disqualified
E002 Exceeding speed limit
E003 Driving while unfit by virtue of disease or physical/mental disability
E004 Drunk Driving
E005 Drunk in Charge (southern Ireland)
E006 Driving without reasonable consideration (Southern Ireland)
E007 Driving without due care and attention (careless driving)
E008 Dangerous driving (southern Ireland)
E009 Driving of dangerously defective vehicle
E010 Parking vehicle in dangerous position
E011 Driving without Insurance
E012 Fraud in Obtaining Insurance
E013 Failure to produce RTA certificate
E014 Accident not reported by the Insured
E015 Sign/Signal not observed
E016 Parking Offence (Southern Ireland)
E017 Duties on occurrence of accident - failure to comply (hit and run)
E018 Unauthorised taking of vehicle
IN10 Using a vehicle uninsured against third party risks
IN14 Knowingly allowed uninsure to drive
LC10 Driving without a licence
LC20 Driving otherwise than in accordance with a licence
LC24 Causing or permitting driving otherwise than in accordance with a licence
LC30 Driving after making a false declaration about fitness when applying for a licence
LC40 Driving a vehicle having failed to notify a disability
LC50 Driving after a licence has been revoked on medical grounds
MR09 Reckless Or Dangerous Driving
MR19 Wilful Failure to Stop and Report Following a Road Accident
MR29 Driving Vehicle Under the Influence Affecting Driver Abilities
MR39 Driving a Vehicle Faster Than the Permitted Speed
MR49 Driving a Vehicle Whilst Disqualified
MR59 Other Driving Disqualification Offence
MS10 Leaving a vehicle in a dangerous position
MS20 Unlawful pillion riding
MS30 Playstreet offences
MS40 Driving with uncorrected defective eyesight or refusing to submit to a test
MS50 Motor racing on the highway
MS60 Offences not covered by other codes
MS70 Driving with uncorrected defective eyesight
MS80 Refusing to submit to an eyesight test
MS90 Failure to give information as to identity of driver etc.
MW10 Contravention of Special Road Regulations (excluding speed limits)
N001 5008007 - Breach of Signal Given by a Constable
N002 5008019 - Driving or permitting a person to drive motor vehicle while uninsured
N003 5008073 - Parking within the limits of a Pelican Crossing
N004 5008075 - Unlawful use of central reservation of Motorway
N005 5008076 - Reversing on Motorway
N006 5008077 - Driving on hard shoulder of Motorway
N007 5008078 - Parking on hard shoulder of Motorway
N008 5008086 - Parking within the limits of a Zebra Crossing
N009 5008087 - Driving classified vehicle on special road
N010 5008089 - Remain on hard shoulder of motorway longer than necessary
N011 5008101 - Stopping on motorway
N012 5008111 - Stopping on approach to a Pelican Crossing
N013 5008115 - Stopping within limits the of Zebra Controlled area
N014 5008117 - Overtaking Moving Vehicle on Zebra Crossing
N015 5008231 - Leaving vehicle in dangerous position
N016 5008237 - Carrying unauthorised passenger on motorbicycle
N017 5008268 - Breach of Traffic Sign eg No Entry, Red Light
N018 5008286 - Driving on a Buslane on Motorway
N019 5010007 - No L Plates displayed
N020 5010009 - Unaccompanied L Driver
N021 5010010 - L Driver carrying passenger on motorcycle
N022 5010011 - L Driver carrying unauthorised passenger on motorcycle
N023 5010012 - L Driver Towing a Trailer
N024 5010015 - No R Plates Displayed
N025 5013021 - No Prescribed Braking System
N026 5013022 - Defective Braking System
N027 5013025 - Defective Steering
N028 5013036 - Carrying child under 14 years without seat belt (front)
N029 5013049 - Defective Tyre - General
N030 5013067 - Driver unable to have proper control of vehicle
N031 5013075 - Failing to Set Handbrake
N032 5013091 - Tyres insufficient to support axle weight
N033 5013115 - Carrying child under 14 years without seatbelt (rear)
N034 5013126 - Exceeding height limit of semi-trailer
N035 5013265 - Using a Mobile Phone whilst Driving
N036 5013268 - Failing to Wear Seat Belt - Driver
N037 5013269 - Driver Carrying Unbelted Child Under 14 Years
N038 5013271 - Driver Carrying Child Under 12 Years without restrain
N039 5013272 - Using a Hand-held Mobile Phone
N040 5013273 - Driver does not have Proper Control of Vehicle
N041 5013274 - Driver does not have Full View of Road and Traffic Ahead
NA01 Causing GBI by driving carelessly/inconsiderately whilst unfit
NA02 Causing GBI by driving carelessly with excess alcohol or drugs
NA03 Wrongful use of a disabled driver's badge
NE99 Non-endorsable offence which can result in disqualification
NI09 GB drivers disqualified in Northern Ireland
NR09 GB drivers revoked under the New Drivers Act in Northern Ireland
PC10 Undefined Contravention of Pedestrian Crossing Regulations
PC20 Contravention of Pedestrian Crossing Regulations with moving vehicle
PC30 Contravention of Pedestrian Crossing Regulations with stationary vehicle
PL10 Driving without ‘L’ plates
PL20 Not accompanied by a qualified person
PL30 Carrying a person not qualified
PL40 Drawing an unauthorised trailer
PL50 Undefined failure to comply with conditions of a Provisional Licence
QI09 GB drivers disqualified in Isle of Man
SP10 Exceeding goods vehicle speed limit
SP20 Exceeding speed limit for type of vehicle (excluding goods or passenger vehicle)
SP30 Exceeding statutory speed limit on a public road
SP40 Exceeding passenger vehicle speed limit
SP50 Exceeding speed limit on a motorway
SP60 Undefined speed limit offence
TS20 Failing to comply with double white lines
TS30 Failing to comply with a ‘Stop’ sign
TS40 Failing to comply with directions of a traffic constable
TS50 Failing to comply with a traffic sign (excluding ‘Stop’ signs, traffic lights or double white lines)
TS60 Failing to comply with a school crossing patrol sign
TS70 Undefined failure to comply with a traffic direction or sign
TT99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
UT10 Taking and driving away a vehicle without consent or an attempt thereat
UT20 Stealing or attempting to steal a vehicle
UT30 Going equipped for stealing or taking a vehicle
UT40 Taking or attempting to take a vehicle without consent, driving or attempting to drive a vehicle knowing it to have been taken without consent, allowing oneself to be carried in or on a vehicle knowing it to have been taken without consent
UT50 Aggravated taking of a vehicle
XX99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
Z001 Non-Road Traffic Act - Fraud
Z002 Non-Road Traffic Act - Robbery
Z003 Non-Road Traffic Act - Theft
Z004 Non-Road Traffic Act - Handling
Z005 Prosecution Pending
Z006 Parking Offence
Z007 Disqualification Under section 34
Z008 Disqualification Under section 35
Date of conviction
*
Please tell us the date of conviction
Day
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Month
1
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7
8
9
10
11
12
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Penalty points
*
Please tell us the number of penalty points
Select the number of penalty points
0
1
2
3
4
5
6
7
8
9
10
11
12
Length of ban
*
Select the duration of any ban
Select the duration of any ban
No Ban
Less than 30 days
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
1 year
2 years
3 years
4 years
5 years
Any more convictions?
*
Yes
No
Conviction code
*
Including convictions, endorsements, fixed penalties, bans or points in the last 5 years? This list shows the most common.
Please choose the conviction code
CU80 Using a mobile phone while driving a motor vehicle
SP30 Exceeding statutory speed limit on a public road
SP50 Exceeding speed limit on a motorway
IN10 Using a vehicle uninsured against third party risks
TS10 Failing to comply with traffic light signals
AC10 Failing to stop and/or give particulars after an accident
AC20 Failing to report an accident within 24 hours
AC30 Undefined accident offence
BA10 Driving while disqualified
BA20 Driving while disqualified by reason of age
BA30 Attempting to drive while disqualified
CD10 Driving without due care and attention
CD20 Driving without reasonable consideration for other road users
CD30 Driving without due care and attention or without reasonable consideration for other road users
CD40 Causing death by careless driving when unfit through drink
CD50 Causing death by careless driving when unfit through drugs
CD60 Causing death by careless driving with alcohol level above the limit
CD70 Causing death by careless driving then failing to supply a specimen for analysis
CD80 Causing death by careless, or inconsiderate, driving
CU10 Using a vehicle with defective brakes
CU20 Causing or likely to cause danger by reason of use of unsuitable vehicle or using a vehicle with parts or accessories (excluding brakes, steering or tyres) in a dangerous condition
CU30 Using a vehicle with defective tyres
CU40 Using a vehicle with defective steering
CU50 Causing or likely to cause danger by reason of load of passengers
CU60 Undefined failure to comply with Construction and Use regulations
CU80 Using a mobile phone while driving a motor vehicle
DD10 Driving in a dangerous manner
DD20 Driving at dangerous speed
DD30 Reckless driving
DD40 Driving in a dangerous manner, at a dangerous speed or recklessly
DD50 Causing death by dangerous driving
DD60 Culpable homicide while driving a vehicle
DD70 Causing death by reckless driving
DD80 Causing death by dangerous driving
DG10 Driving or attempting to drive with drug level above specified limit
DG40 In charge of a vehicle whilst drug level above specified limit
DG60 Causing death by careless driving with drug level above the limit
DR10 Driving or attempting to drive with blood alcohol level above limit
DR20 Driving or attempting to drive while unfit through drink or drugs
DR30 Driving or attempting to drive then refusing to supply a specimen or blood or urine for laboratory testing
DR40 In charge of a vehicle while blood alcohol level above limit
DR50 In charge of a vehicle while unfit through drink or drugs
DR60 In charge of a vehicle then refusing to supply a specimen of blood or urine for laboratory testing
DR70 Failure to supply specimen for breath test
DR80 Driving or attempting to drive when unfit through drugs
DR90 In charge of a vehicle when unfit through drugs
E001 No Driving licence - driving while disqualified
E002 Exceeding speed limit
E003 Driving while unfit by virtue of disease or physical/mental disability
E004 Drunk Driving
E005 Drunk in Charge (southern Ireland)
E006 Driving without reasonable consideration (Southern Ireland)
E007 Driving without due care and attention (careless driving)
E008 Dangerous driving (southern Ireland)
E009 Driving of dangerously defective vehicle
E010 Parking vehicle in dangerous position
E011 Driving without Insurance
E012 Fraud in Obtaining Insurance
E013 Failure to produce RTA certificate
E014 Accident not reported by the Insured
E015 Sign/Signal not observed
E016 Parking Offence (Southern Ireland)
E017 Duties on occurrence of accident - failure to comply (hit and run)
E018 Unauthorised taking of vehicle
IN10 Using a vehicle uninsured against third party risks
IN14 Knowingly allowed uninsure to drive
LC10 Driving without a licence
LC20 Driving otherwise than in accordance with a licence
LC24 Causing or permitting driving otherwise than in accordance with a licence
LC30 Driving after making a false declaration about fitness when applying for a licence
LC40 Driving a vehicle having failed to notify a disability
LC50 Driving after a licence has been revoked on medical grounds
MR09 Reckless Or Dangerous Driving
MR19 Wilful Failure to Stop and Report Following a Road Accident
MR29 Driving Vehicle Under the Influence Affecting Driver Abilities
MR39 Driving a Vehicle Faster Than the Permitted Speed
MR49 Driving a Vehicle Whilst Disqualified
MR59 Other Driving Disqualification Offence
MS10 Leaving a vehicle in a dangerous position
MS20 Unlawful pillion riding
MS30 Playstreet offences
MS40 Driving with uncorrected defective eyesight or refusing to submit to a test
MS50 Motor racing on the highway
MS60 Offences not covered by other codes
MS70 Driving with uncorrected defective eyesight
MS80 Refusing to submit to an eyesight test
MS90 Failure to give information as to identity of driver etc.
MW10 Contravention of Special Road Regulations (excluding speed limits)
N001 5008007 - Breach of Signal Given by a Constable
N002 5008019 - Driving or permitting a person to drive motor vehicle while uninsured
N003 5008073 - Parking within the limits of a Pelican Crossing
N004 5008075 - Unlawful use of central reservation of Motorway
N005 5008076 - Reversing on Motorway
N006 5008077 - Driving on hard shoulder of Motorway
N007 5008078 - Parking on hard shoulder of Motorway
N008 5008086 - Parking within the limits of a Zebra Crossing
N009 5008087 - Driving classified vehicle on special road
N010 5008089 - Remain on hard shoulder of motorway longer than necessary
N011 5008101 - Stopping on motorway
N012 5008111 - Stopping on approach to a Pelican Crossing
N013 5008115 - Stopping within limits the of Zebra Controlled area
N014 5008117 - Overtaking Moving Vehicle on Zebra Crossing
N015 5008231 - Leaving vehicle in dangerous position
N016 5008237 - Carrying unauthorised passenger on motorbicycle
N017 5008268 - Breach of Traffic Sign eg No Entry, Red Light
N018 5008286 - Driving on a Buslane on Motorway
N019 5010007 - No L Plates displayed
N020 5010009 - Unaccompanied L Driver
N021 5010010 - L Driver carrying passenger on motorcycle
N022 5010011 - L Driver carrying unauthorised passenger on motorcycle
N023 5010012 - L Driver Towing a Trailer
N024 5010015 - No R Plates Displayed
N025 5013021 - No Prescribed Braking System
N026 5013022 - Defective Braking System
N027 5013025 - Defective Steering
N028 5013036 - Carrying child under 14 years without seat belt (front)
N029 5013049 - Defective Tyre - General
N030 5013067 - Driver unable to have proper control of vehicle
N031 5013075 - Failing to Set Handbrake
N032 5013091 - Tyres insufficient to support axle weight
N033 5013115 - Carrying child under 14 years without seatbelt (rear)
N034 5013126 - Exceeding height limit of semi-trailer
N035 5013265 - Using a Mobile Phone whilst Driving
N036 5013268 - Failing to Wear Seat Belt - Driver
N037 5013269 - Driver Carrying Unbelted Child Under 14 Years
N038 5013271 - Driver Carrying Child Under 12 Years without restrain
N039 5013272 - Using a Hand-held Mobile Phone
N040 5013273 - Driver does not have Proper Control of Vehicle
N041 5013274 - Driver does not have Full View of Road and Traffic Ahead
NA01 Causing GBI by driving carelessly/inconsiderately whilst unfit
NA02 Causing GBI by driving carelessly with excess alcohol or drugs
NA03 Wrongful use of a disabled driver's badge
NE99 Non-endorsable offence which can result in disqualification
NI09 GB drivers disqualified in Northern Ireland
NR09 GB drivers revoked under the New Drivers Act in Northern Ireland
PC10 Undefined Contravention of Pedestrian Crossing Regulations
PC20 Contravention of Pedestrian Crossing Regulations with moving vehicle
PC30 Contravention of Pedestrian Crossing Regulations with stationary vehicle
PL10 Driving without ‘L’ plates
PL20 Not accompanied by a qualified person
PL30 Carrying a person not qualified
PL40 Drawing an unauthorised trailer
PL50 Undefined failure to comply with conditions of a Provisional Licence
QI09 GB drivers disqualified in Isle of Man
SP10 Exceeding goods vehicle speed limit
SP20 Exceeding speed limit for type of vehicle (excluding goods or passenger vehicle)
SP30 Exceeding statutory speed limit on a public road
SP40 Exceeding passenger vehicle speed limit
SP50 Exceeding speed limit on a motorway
SP60 Undefined speed limit offence
TS20 Failing to comply with double white lines
TS30 Failing to comply with a ‘Stop’ sign
TS40 Failing to comply with directions of a traffic constable
TS50 Failing to comply with a traffic sign (excluding ‘Stop’ signs, traffic lights or double white lines)
TS60 Failing to comply with a school crossing patrol sign
TS70 Undefined failure to comply with a traffic direction or sign
TT99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
UT10 Taking and driving away a vehicle without consent or an attempt thereat
UT20 Stealing or attempting to steal a vehicle
UT30 Going equipped for stealing or taking a vehicle
UT40 Taking or attempting to take a vehicle without consent, driving or attempting to drive a vehicle knowing it to have been taken without consent, allowing oneself to be carried in or on a vehicle knowing it to have been taken without consent
UT50 Aggravated taking of a vehicle
XX99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
Z001 Non-Road Traffic Act - Fraud
Z002 Non-Road Traffic Act - Robbery
Z003 Non-Road Traffic Act - Theft
Z004 Non-Road Traffic Act - Handling
Z005 Prosecution Pending
Z006 Parking Offence
Z007 Disqualification Under section 34
Z008 Disqualification Under section 35
Date of conviction
*
Please tell us the date of conviction
Day
1
2
3
4
5
6
7
8
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14
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7
8
9
10
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12
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Penalty points
*
Please tell us the number of penalty points
Select the number of penalty points
0
1
2
3
4
5
6
7
8
9
10
11
12
Length of ban
*
Select the duration of any ban
Select the duration of any ban
No Ban
Less than 30 days
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
1 year
2 years
3 years
4 years
5 years
Any more convictions?
*
Yes
No
Conviction code
*
Including convictions, endorsements, fixed penalties, bans or points in the last 5 years? This list shows the most common.
Please choose the conviction code
CU80 Using a mobile phone while driving a motor vehicle
SP30 Exceeding statutory speed limit on a public road
SP50 Exceeding speed limit on a motorway
IN10 Using a vehicle uninsured against third party risks
TS10 Failing to comply with traffic light signals
AC10 Failing to stop and/or give particulars after an accident
AC20 Failing to report an accident within 24 hours
AC30 Undefined accident offence
BA10 Driving while disqualified
BA20 Driving while disqualified by reason of age
BA30 Attempting to drive while disqualified
CD10 Driving without due care and attention
CD20 Driving without reasonable consideration for other road users
CD30 Driving without due care and attention or without reasonable consideration for other road users
CD40 Causing death by careless driving when unfit through drink
CD50 Causing death by careless driving when unfit through drugs
CD60 Causing death by careless driving with alcohol level above the limit
CD70 Causing death by careless driving then failing to supply a specimen for analysis
CD80 Causing death by careless, or inconsiderate, driving
CU10 Using a vehicle with defective brakes
CU20 Causing or likely to cause danger by reason of use of unsuitable vehicle or using a vehicle with parts or accessories (excluding brakes, steering or tyres) in a dangerous condition
CU30 Using a vehicle with defective tyres
CU40 Using a vehicle with defective steering
CU50 Causing or likely to cause danger by reason of load of passengers
CU60 Undefined failure to comply with Construction and Use regulations
CU80 Using a mobile phone while driving a motor vehicle
DD10 Driving in a dangerous manner
DD20 Driving at dangerous speed
DD30 Reckless driving
DD40 Driving in a dangerous manner, at a dangerous speed or recklessly
DD50 Causing death by dangerous driving
DD60 Culpable homicide while driving a vehicle
DD70 Causing death by reckless driving
DD80 Causing death by dangerous driving
DG10 Driving or attempting to drive with drug level above specified limit
DG40 In charge of a vehicle whilst drug level above specified limit
DG60 Causing death by careless driving with drug level above the limit
DR10 Driving or attempting to drive with blood alcohol level above limit
DR20 Driving or attempting to drive while unfit through drink or drugs
DR30 Driving or attempting to drive then refusing to supply a specimen or blood or urine for laboratory testing
DR40 In charge of a vehicle while blood alcohol level above limit
DR50 In charge of a vehicle while unfit through drink or drugs
DR60 In charge of a vehicle then refusing to supply a specimen of blood or urine for laboratory testing
DR70 Failure to supply specimen for breath test
DR80 Driving or attempting to drive when unfit through drugs
DR90 In charge of a vehicle when unfit through drugs
E001 No Driving licence - driving while disqualified
E002 Exceeding speed limit
E003 Driving while unfit by virtue of disease or physical/mental disability
E004 Drunk Driving
E005 Drunk in Charge (southern Ireland)
E006 Driving without reasonable consideration (Southern Ireland)
E007 Driving without due care and attention (careless driving)
E008 Dangerous driving (southern Ireland)
E009 Driving of dangerously defective vehicle
E010 Parking vehicle in dangerous position
E011 Driving without Insurance
E012 Fraud in Obtaining Insurance
E013 Failure to produce RTA certificate
E014 Accident not reported by the Insured
E015 Sign/Signal not observed
E016 Parking Offence (Southern Ireland)
E017 Duties on occurrence of accident - failure to comply (hit and run)
E018 Unauthorised taking of vehicle
IN10 Using a vehicle uninsured against third party risks
IN14 Knowingly allowed uninsure to drive
LC10 Driving without a licence
LC20 Driving otherwise than in accordance with a licence
LC24 Causing or permitting driving otherwise than in accordance with a licence
LC30 Driving after making a false declaration about fitness when applying for a licence
LC40 Driving a vehicle having failed to notify a disability
LC50 Driving after a licence has been revoked on medical grounds
MR09 Reckless Or Dangerous Driving
MR19 Wilful Failure to Stop and Report Following a Road Accident
MR29 Driving Vehicle Under the Influence Affecting Driver Abilities
MR39 Driving a Vehicle Faster Than the Permitted Speed
MR49 Driving a Vehicle Whilst Disqualified
MR59 Other Driving Disqualification Offence
MS10 Leaving a vehicle in a dangerous position
MS20 Unlawful pillion riding
MS30 Playstreet offences
MS40 Driving with uncorrected defective eyesight or refusing to submit to a test
MS50 Motor racing on the highway
MS60 Offences not covered by other codes
MS70 Driving with uncorrected defective eyesight
MS80 Refusing to submit to an eyesight test
MS90 Failure to give information as to identity of driver etc.
MW10 Contravention of Special Road Regulations (excluding speed limits)
N001 5008007 - Breach of Signal Given by a Constable
N002 5008019 - Driving or permitting a person to drive motor vehicle while uninsured
N003 5008073 - Parking within the limits of a Pelican Crossing
N004 5008075 - Unlawful use of central reservation of Motorway
N005 5008076 - Reversing on Motorway
N006 5008077 - Driving on hard shoulder of Motorway
N007 5008078 - Parking on hard shoulder of Motorway
N008 5008086 - Parking within the limits of a Zebra Crossing
N009 5008087 - Driving classified vehicle on special road
N010 5008089 - Remain on hard shoulder of motorway longer than necessary
N011 5008101 - Stopping on motorway
N012 5008111 - Stopping on approach to a Pelican Crossing
N013 5008115 - Stopping within limits the of Zebra Controlled area
N014 5008117 - Overtaking Moving Vehicle on Zebra Crossing
N015 5008231 - Leaving vehicle in dangerous position
N016 5008237 - Carrying unauthorised passenger on motorbicycle
N017 5008268 - Breach of Traffic Sign eg No Entry, Red Light
N018 5008286 - Driving on a Buslane on Motorway
N019 5010007 - No L Plates displayed
N020 5010009 - Unaccompanied L Driver
N021 5010010 - L Driver carrying passenger on motorcycle
N022 5010011 - L Driver carrying unauthorised passenger on motorcycle
N023 5010012 - L Driver Towing a Trailer
N024 5010015 - No R Plates Displayed
N025 5013021 - No Prescribed Braking System
N026 5013022 - Defective Braking System
N027 5013025 - Defective Steering
N028 5013036 - Carrying child under 14 years without seat belt (front)
N029 5013049 - Defective Tyre - General
N030 5013067 - Driver unable to have proper control of vehicle
N031 5013075 - Failing to Set Handbrake
N032 5013091 - Tyres insufficient to support axle weight
N033 5013115 - Carrying child under 14 years without seatbelt (rear)
N034 5013126 - Exceeding height limit of semi-trailer
N035 5013265 - Using a Mobile Phone whilst Driving
N036 5013268 - Failing to Wear Seat Belt - Driver
N037 5013269 - Driver Carrying Unbelted Child Under 14 Years
N038 5013271 - Driver Carrying Child Under 12 Years without restrain
N039 5013272 - Using a Hand-held Mobile Phone
N040 5013273 - Driver does not have Proper Control of Vehicle
N041 5013274 - Driver does not have Full View of Road and Traffic Ahead
NA01 Causing GBI by driving carelessly/inconsiderately whilst unfit
NA02 Causing GBI by driving carelessly with excess alcohol or drugs
NA03 Wrongful use of a disabled driver's badge
NE99 Non-endorsable offence which can result in disqualification
NI09 GB drivers disqualified in Northern Ireland
NR09 GB drivers revoked under the New Drivers Act in Northern Ireland
PC10 Undefined Contravention of Pedestrian Crossing Regulations
PC20 Contravention of Pedestrian Crossing Regulations with moving vehicle
PC30 Contravention of Pedestrian Crossing Regulations with stationary vehicle
PL10 Driving without ‘L’ plates
PL20 Not accompanied by a qualified person
PL30 Carrying a person not qualified
PL40 Drawing an unauthorised trailer
PL50 Undefined failure to comply with conditions of a Provisional Licence
QI09 GB drivers disqualified in Isle of Man
SP10 Exceeding goods vehicle speed limit
SP20 Exceeding speed limit for type of vehicle (excluding goods or passenger vehicle)
SP30 Exceeding statutory speed limit on a public road
SP40 Exceeding passenger vehicle speed limit
SP50 Exceeding speed limit on a motorway
SP60 Undefined speed limit offence
TS20 Failing to comply with double white lines
TS30 Failing to comply with a ‘Stop’ sign
TS40 Failing to comply with directions of a traffic constable
TS50 Failing to comply with a traffic sign (excluding ‘Stop’ signs, traffic lights or double white lines)
TS60 Failing to comply with a school crossing patrol sign
TS70 Undefined failure to comply with a traffic direction or sign
TT99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
UT10 Taking and driving away a vehicle without consent or an attempt thereat
UT20 Stealing or attempting to steal a vehicle
UT30 Going equipped for stealing or taking a vehicle
UT40 Taking or attempting to take a vehicle without consent, driving or attempting to drive a vehicle knowing it to have been taken without consent, allowing oneself to be carried in or on a vehicle knowing it to have been taken without consent
UT50 Aggravated taking of a vehicle
XX99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
Z001 Non-Road Traffic Act - Fraud
Z002 Non-Road Traffic Act - Robbery
Z003 Non-Road Traffic Act - Theft
Z004 Non-Road Traffic Act - Handling
Z005 Prosecution Pending
Z006 Parking Offence
Z007 Disqualification Under section 34
Z008 Disqualification Under section 35
Date of conviction
*
Please tell us the date of conviction
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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18
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Month
1
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5
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7
8
9
10
11
12
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Penalty points
*
Please tell us the number of penalty points
Select the number of penalty points
0
1
2
3
4
5
6
7
8
9
10
11
12
Length of ban
*
Select the duration of any ban
Select the duration of any ban
No Ban
Less than 30 days
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
1 year
2 years
3 years
4 years
5 years
Any more convictions?
*
Yes
No
Conviction code
*
Including convictions, endorsements, fixed penalties, bans or points in the last 5 years? This list shows the most common.
Please choose the conviction code
CU80 Using a mobile phone while driving a motor vehicle
SP30 Exceeding statutory speed limit on a public road
SP50 Exceeding speed limit on a motorway
IN10 Using a vehicle uninsured against third party risks
TS10 Failing to comply with traffic light signals
AC10 Failing to stop and/or give particulars after an accident
AC20 Failing to report an accident within 24 hours
AC30 Undefined accident offence
BA10 Driving while disqualified
BA20 Driving while disqualified by reason of age
BA30 Attempting to drive while disqualified
CD10 Driving without due care and attention
CD20 Driving without reasonable consideration for other road users
CD30 Driving without due care and attention or without reasonable consideration for other road users
CD40 Causing death by careless driving when unfit through drink
CD50 Causing death by careless driving when unfit through drugs
CD60 Causing death by careless driving with alcohol level above the limit
CD70 Causing death by careless driving then failing to supply a specimen for analysis
CD80 Causing death by careless, or inconsiderate, driving
CU10 Using a vehicle with defective brakes
CU20 Causing or likely to cause danger by reason of use of unsuitable vehicle or using a vehicle with parts or accessories (excluding brakes, steering or tyres) in a dangerous condition
CU30 Using a vehicle with defective tyres
CU40 Using a vehicle with defective steering
CU50 Causing or likely to cause danger by reason of load of passengers
CU60 Undefined failure to comply with Construction and Use regulations
CU80 Using a mobile phone while driving a motor vehicle
DD10 Driving in a dangerous manner
DD20 Driving at dangerous speed
DD30 Reckless driving
DD40 Driving in a dangerous manner, at a dangerous speed or recklessly
DD50 Causing death by dangerous driving
DD60 Culpable homicide while driving a vehicle
DD70 Causing death by reckless driving
DD80 Causing death by dangerous driving
DG10 Driving or attempting to drive with drug level above specified limit
DG40 In charge of a vehicle whilst drug level above specified limit
DG60 Causing death by careless driving with drug level above the limit
DR10 Driving or attempting to drive with blood alcohol level above limit
DR20 Driving or attempting to drive while unfit through drink or drugs
DR30 Driving or attempting to drive then refusing to supply a specimen or blood or urine for laboratory testing
DR40 In charge of a vehicle while blood alcohol level above limit
DR50 In charge of a vehicle while unfit through drink or drugs
DR60 In charge of a vehicle then refusing to supply a specimen of blood or urine for laboratory testing
DR70 Failure to supply specimen for breath test
DR80 Driving or attempting to drive when unfit through drugs
DR90 In charge of a vehicle when unfit through drugs
E001 No Driving licence - driving while disqualified
E002 Exceeding speed limit
E003 Driving while unfit by virtue of disease or physical/mental disability
E004 Drunk Driving
E005 Drunk in Charge (southern Ireland)
E006 Driving without reasonable consideration (Southern Ireland)
E007 Driving without due care and attention (careless driving)
E008 Dangerous driving (southern Ireland)
E009 Driving of dangerously defective vehicle
E010 Parking vehicle in dangerous position
E011 Driving without Insurance
E012 Fraud in Obtaining Insurance
E013 Failure to produce RTA certificate
E014 Accident not reported by the Insured
E015 Sign/Signal not observed
E016 Parking Offence (Southern Ireland)
E017 Duties on occurrence of accident - failure to comply (hit and run)
E018 Unauthorised taking of vehicle
IN10 Using a vehicle uninsured against third party risks
IN14 Knowingly allowed uninsure to drive
LC10 Driving without a licence
LC20 Driving otherwise than in accordance with a licence
LC24 Causing or permitting driving otherwise than in accordance with a licence
LC30 Driving after making a false declaration about fitness when applying for a licence
LC40 Driving a vehicle having failed to notify a disability
LC50 Driving after a licence has been revoked on medical grounds
MR09 Reckless Or Dangerous Driving
MR19 Wilful Failure to Stop and Report Following a Road Accident
MR29 Driving Vehicle Under the Influence Affecting Driver Abilities
MR39 Driving a Vehicle Faster Than the Permitted Speed
MR49 Driving a Vehicle Whilst Disqualified
MR59 Other Driving Disqualification Offence
MS10 Leaving a vehicle in a dangerous position
MS20 Unlawful pillion riding
MS30 Playstreet offences
MS40 Driving with uncorrected defective eyesight or refusing to submit to a test
MS50 Motor racing on the highway
MS60 Offences not covered by other codes
MS70 Driving with uncorrected defective eyesight
MS80 Refusing to submit to an eyesight test
MS90 Failure to give information as to identity of driver etc.
MW10 Contravention of Special Road Regulations (excluding speed limits)
N001 5008007 - Breach of Signal Given by a Constable
N002 5008019 - Driving or permitting a person to drive motor vehicle while uninsured
N003 5008073 - Parking within the limits of a Pelican Crossing
N004 5008075 - Unlawful use of central reservation of Motorway
N005 5008076 - Reversing on Motorway
N006 5008077 - Driving on hard shoulder of Motorway
N007 5008078 - Parking on hard shoulder of Motorway
N008 5008086 - Parking within the limits of a Zebra Crossing
N009 5008087 - Driving classified vehicle on special road
N010 5008089 - Remain on hard shoulder of motorway longer than necessary
N011 5008101 - Stopping on motorway
N012 5008111 - Stopping on approach to a Pelican Crossing
N013 5008115 - Stopping within limits the of Zebra Controlled area
N014 5008117 - Overtaking Moving Vehicle on Zebra Crossing
N015 5008231 - Leaving vehicle in dangerous position
N016 5008237 - Carrying unauthorised passenger on motorbicycle
N017 5008268 - Breach of Traffic Sign eg No Entry, Red Light
N018 5008286 - Driving on a Buslane on Motorway
N019 5010007 - No L Plates displayed
N020 5010009 - Unaccompanied L Driver
N021 5010010 - L Driver carrying passenger on motorcycle
N022 5010011 - L Driver carrying unauthorised passenger on motorcycle
N023 5010012 - L Driver Towing a Trailer
N024 5010015 - No R Plates Displayed
N025 5013021 - No Prescribed Braking System
N026 5013022 - Defective Braking System
N027 5013025 - Defective Steering
N028 5013036 - Carrying child under 14 years without seat belt (front)
N029 5013049 - Defective Tyre - General
N030 5013067 - Driver unable to have proper control of vehicle
N031 5013075 - Failing to Set Handbrake
N032 5013091 - Tyres insufficient to support axle weight
N033 5013115 - Carrying child under 14 years without seatbelt (rear)
N034 5013126 - Exceeding height limit of semi-trailer
N035 5013265 - Using a Mobile Phone whilst Driving
N036 5013268 - Failing to Wear Seat Belt - Driver
N037 5013269 - Driver Carrying Unbelted Child Under 14 Years
N038 5013271 - Driver Carrying Child Under 12 Years without restrain
N039 5013272 - Using a Hand-held Mobile Phone
N040 5013273 - Driver does not have Proper Control of Vehicle
N041 5013274 - Driver does not have Full View of Road and Traffic Ahead
NA01 Causing GBI by driving carelessly/inconsiderately whilst unfit
NA02 Causing GBI by driving carelessly with excess alcohol or drugs
NA03 Wrongful use of a disabled driver's badge
NE99 Non-endorsable offence which can result in disqualification
NI09 GB drivers disqualified in Northern Ireland
NR09 GB drivers revoked under the New Drivers Act in Northern Ireland
PC10 Undefined Contravention of Pedestrian Crossing Regulations
PC20 Contravention of Pedestrian Crossing Regulations with moving vehicle
PC30 Contravention of Pedestrian Crossing Regulations with stationary vehicle
PL10 Driving without ‘L’ plates
PL20 Not accompanied by a qualified person
PL30 Carrying a person not qualified
PL40 Drawing an unauthorised trailer
PL50 Undefined failure to comply with conditions of a Provisional Licence
QI09 GB drivers disqualified in Isle of Man
SP10 Exceeding goods vehicle speed limit
SP20 Exceeding speed limit for type of vehicle (excluding goods or passenger vehicle)
SP30 Exceeding statutory speed limit on a public road
SP40 Exceeding passenger vehicle speed limit
SP50 Exceeding speed limit on a motorway
SP60 Undefined speed limit offence
TS20 Failing to comply with double white lines
TS30 Failing to comply with a ‘Stop’ sign
TS40 Failing to comply with directions of a traffic constable
TS50 Failing to comply with a traffic sign (excluding ‘Stop’ signs, traffic lights or double white lines)
TS60 Failing to comply with a school crossing patrol sign
TS70 Undefined failure to comply with a traffic direction or sign
TT99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
UT10 Taking and driving away a vehicle without consent or an attempt thereat
UT20 Stealing or attempting to steal a vehicle
UT30 Going equipped for stealing or taking a vehicle
UT40 Taking or attempting to take a vehicle without consent, driving or attempting to drive a vehicle knowing it to have been taken without consent, allowing oneself to be carried in or on a vehicle knowing it to have been taken without consent
UT50 Aggravated taking of a vehicle
XX99 To signify a disqualification under ‘totting-up’ procedure. Demerit points apply for offences causing the disqualification
Z001 Non-Road Traffic Act - Fraud
Z002 Non-Road Traffic Act - Robbery
Z003 Non-Road Traffic Act - Theft
Z004 Non-Road Traffic Act - Handling
Z005 Prosecution Pending
Z006 Parking Offence
Z007 Disqualification Under section 34
Z008 Disqualification Under section 35
Date of conviction
*
Please tell us the date of conviction
Day
1
2
3
4
5
6
7
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Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Penalty points
*
Please tell us the number of penalty points
Select the number of penalty points
0
1
2
3
4
5
6
7
8
9
10
11
12
Length of ban
*
Select the duration of any ban
Select the duration of any ban
No Ban
Less than 30 days
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
1 year
2 years
3 years
4 years
5 years
You have reached the limit for number of convictions. If this driver has any more convictions than those already disclosed we are unable to offer a quote.
Have they had any incidents, accidents, fires, thefts, malicious damage claims, or glass claims, whether fault, non-fault or pending, however minor in the last 5 years?
*
Yes
No
Claim Type
*
Please select the best description of the incident
Accident - Partial Blame - Claim Made
Accident - Partial Blame - No Claim Made
Fire/Flood/Water Damage - Claim Made
Fire/Flood/Water Damage - No Claim Made
Malicious Damage/Vandalism - Claim Made
Malicious Damage/Vandalism - No Claim Made
Theft Or Attempted Theft From Car - Claim Made
Theft Or Attempted Theft From Car - No Claim Made
Theft Or Attempted Theft Of Car - Claim Made
Theft Or Attempted Theft Of Car - No Claim Made
Third Party Vehicle/Object Hit You - Recovery Made
Third Party Vehicle/Object Hit You - Recovery O/S
Unknown Accident - Historical - Claim Made
Unknown Accident - Historical - No Claim Made
Unknown Third Party Hit You - Claim Made
Unknown Third Party Hit You - No Claim Made
Windscreen/Glass Damage
You Hit Third Party Person - Claim Made/Pending
You Hit Third Party Person - No Claim Made
You Hit Third Party Vehicle/Object - Claim Made
You Hit Third Party Vehicle/Object - No Claim Made
Please select the description that best matches the circumstances of the incident.
Date
*
Day
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Year
2019
2018
2017
2016
2015
2014
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2012
2011
2010
2009
Claim costs
*
If known please let us know the estimated claims costs
No cost
less than £1K
£1K - £3K
£3k - £5K
£5k - £10K
£10K+
Any more claims?
*
Yes
No
Claim Type
*
Please select the best description of the incident
Accident - Partial Blame - Claim Made
Accident - Partial Blame - No Claim Made
Fire/Flood/Water Damage - Claim Made
Fire/Flood/Water Damage - No Claim Made
Malicious Damage/Vandalism - Claim Made
Malicious Damage/Vandalism - No Claim Made
Theft Or Attempted Theft From Car - Claim Made
Theft Or Attempted Theft From Car - No Claim Made
Theft Or Attempted Theft Of Car - Claim Made
Theft Or Attempted Theft Of Car - No Claim Made
Third Party Vehicle/Object Hit You - Recovery Made
Third Party Vehicle/Object Hit You - Recovery O/S
Unknown Accident - Historical - Claim Made
Unknown Accident - Historical - No Claim Made
Unknown Third Party Hit You - Claim Made
Unknown Third Party Hit You - No Claim Made
Windscreen/Glass Damage
You Hit Third Party Person - Claim Made/Pending
You Hit Third Party Person - No Claim Made
You Hit Third Party Vehicle/Object - Claim Made
You Hit Third Party Vehicle/Object - No Claim Made
Please select the description that best matches the circumstances of the incident.
Date
*
Day
1
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Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Claim costs
*
If known please let us know the estimated claims costs
No cost
less than £1K
£1K - £3K
£3k - £5K
£5k - £10K
£10K+
Any more claims?
*
Yes
No
Claim Type
*
Please select the best description of the incident
Accident - Partial Blame - Claim Made
Accident - Partial Blame - No Claim Made
Fire/Flood/Water Damage - Claim Made
Fire/Flood/Water Damage - No Claim Made
Malicious Damage/Vandalism - Claim Made
Malicious Damage/Vandalism - No Claim Made
Theft Or Attempted Theft From Car - Claim Made
Theft Or Attempted Theft From Car - No Claim Made
Theft Or Attempted Theft Of Car - Claim Made
Theft Or Attempted Theft Of Car - No Claim Made
Third Party Vehicle/Object Hit You - Recovery Made
Third Party Vehicle/Object Hit You - Recovery O/S
Unknown Accident - Historical - Claim Made
Unknown Accident - Historical - No Claim Made
Unknown Third Party Hit You - Claim Made
Unknown Third Party Hit You - No Claim Made
Windscreen/Glass Damage
You Hit Third Party Person - Claim Made/Pending
You Hit Third Party Person - No Claim Made
You Hit Third Party Vehicle/Object - Claim Made
You Hit Third Party Vehicle/Object - No Claim Made
Please select the description that best matches the circumstances of the incident.
Date
*
Day
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9
10
11
12
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Claim costs
*
If known please let us know the estimated claims costs
No cost
less than £1K
£1K - £3K
£3k - £5K
£5k - £10K
£10K+
Any more claims?
*
Yes
No
Claim Type
*
Please select the best description of the incident
Accident - Partial Blame - Claim Made
Accident - Partial Blame - No Claim Made
Fire/Flood/Water Damage - Claim Made
Fire/Flood/Water Damage - No Claim Made
Malicious Damage/Vandalism - Claim Made
Malicious Damage/Vandalism - No Claim Made
Theft Or Attempted Theft From Car - Claim Made
Theft Or Attempted Theft From Car - No Claim Made
Theft Or Attempted Theft Of Car - Claim Made
Theft Or Attempted Theft Of Car - No Claim Made
Third Party Vehicle/Object Hit You - Recovery Made
Third Party Vehicle/Object Hit You - Recovery O/S
Unknown Accident - Historical - Claim Made
Unknown Accident - Historical - No Claim Made
Unknown Third Party Hit You - Claim Made
Unknown Third Party Hit You - No Claim Made
Windscreen/Glass Damage
You Hit Third Party Person - Claim Made/Pending
You Hit Third Party Person - No Claim Made
You Hit Third Party Vehicle/Object - Claim Made
You Hit Third Party Vehicle/Object - No Claim Made
Please select the description that best matches the circumstances of the incident.
Date
*
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
Claim costs
*
If known please let us know the estimated claims costs
No cost
less than £1K
£1K - £3K
£3k - £5K
£5k - £10K
£10K+
You have reached the limit for number of claims. If this driver has any more claims than those already disclosed we are unable to offer a quote.
Do they have any pending or served criminal convictions?
*
This is not referring to motoring offences.
Yes
No
Please provide as much information as possible about their criminal conviction(s)
*
Details might include: date, offence code, fine, sentencing
Does this driver suffer from any disability or medical condition?
*
This includes disabilities or medical conditions which have not been notified to the DVLA or which have been notified but resulted in the refusal of a driving licence.
Yes
No
Please provide as much information about the disability or medical condition.
*
BusinessPartnerAddress
LengthOfUKResidency
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