The Easy way to insure your motorhome

Your Details

Title:

Forename:

Surname:

Date of Birth:

Day:

Month:

Year:

Occupation:

House Name/No.

Post Code:

Email Address:

Phone Number: (Include area code)

Vehicle Details

Make / Manufacturer: (e.g. Auto-Trail)

Model: (e.g. Cherokee)

Year of Manufacture:

Engine Size: (cc)

Left / Right Hand Drive:

Left Hand Drive
Right Hand Drive

Value (£)

Vehicle Owned for: (e.g. Recreation)

Your Cover

What type of cover would you like?

Comprehensive
Third Party Fire & Theft (max. value £5000.00)

Drivers

Insured Only
Insured & Named

Date you passed your driving test: (approx.)

Day:

Month:

Year:

Accidents or Claims

Have you made a claim?

Yes
No

If you have had more than two incidents we request you contact our office direct on 0845 3456 001 for a quotation.

Claim 1

Date of Claim:

Day:

Month:

Year:

Type of Claim:

Brief Circumstances of Claim:

Do you have any additional claims?

Yes
No

Claim 2

Date of 2nd Claim:

Day:

Month:

Year:

Type of 2nd Claim:

Brief Circumstances of Claim:

Motoring Convictions

Have you any previous motoring convictions?

Yes
No

If you have have more than two motoring convictions we request you contact our office direct on 0845 3456 001 for a quotation.

Conviction 1

Date of Conviction:

Day:

Month:

Year:

No. of Points Held:

Conviction Code:

Conviction Fine Amount:

Do you have any additional convictions?

Yes
No

Conviction 2

Date of 2nd Conviction:

Day:

Month:

Year:

No. of Points Held:

Conviction Code:

Conviction Fine Amount:

Other Details

Current No Claims Bonus: (On this vehicle)

Where is your Motorhome kept?

At home on drive
At home on road
In Storage CaSSOA
Other

Other Vehicle No Claims

As you don't have any No Claims Bonus on your vehicle, please let us know about the No Claims Bonus you have on your Private car policy?

Other Vehicle No Claims Bonus: (On this vehicle)

Are you a member of the Caravan Club?

Yes
No

Annual Mileage: (Discounts available for 5,000 miles or less)

Preferred Method of Contact

We will shortly provide you with a quotation tailored to your requirements. Please indicate your preferred method of contact:

How would you like us to contact you?

Phone
Email Mobile

Agree Terms & Submit

Please tick the box if you agree to all our Terms and Conditions.

You are a UK resident, the registered owner of the vehicle, and the main user
Your motorhome is registered and kept in Great Britain, Isle of Man, and Channel Isles only You and any additional driver are aged between 25 and 75
You and any additional driver have no disability which requires the DVLA to be notified
You and any additional driver must hold a current, valid UK driving licence
No driver has any criminal convictions (other than for motoring offences) been refused insurance or had any terms imposed
No driver of the vehicle will require business use in relation to a driving occupation e.g Taxi driver, courier, motor-trader etc.
No driver of the vehicle is a professional sports person, actor, actress, or TV/Radio Presenter.
Your vehicle has no performance or cosmetic modifications

I agree to above terms and have read the GDPR privacy statement.

Apply Online

Your Details

Title:

Forename:

Surname:

Date of Birth:

Occupation:

House Name/No.

Post Code:

Email Address:

Phone Number: (Include area code)

Vehicle Details

Make / Manufacturer: (e.g. Auto-Trail)

Model: (e.g. Cherokee)

Year of Manufacture:

Engine Size: (cc)

Left / Right Hand Drive:

Value (£)

Vehicle Owned for: (e.g. Recreation)

Your Cover

What type of cover would you like?

Drivers

Date you passed your driving test: (approx.)

Accidents or Claims

Have you made a claim?

Claim 1

Date of Claim:

Type of Claim:

Brief Circumstances of Claim:

Do you have any additional claims?

Claim 2

Date of 2nd Claim:

Type of 2nd Claim:

Brief Circumstances of Claim:

Motoring Convictions

Have you any previous motoring convictions?

Conviction 1

Date of Conviction:

No. of Points Held:

Conviction Code:

Conviction Fine Amount:

Do you have any additional convictions?

Conviction 2

Date of 2nd Conviction:

No. of Points Held:

Conviction Code:

Conviction Fine Amount:

Second Driver

Would you like to add a Second Driver to the Policy?

Second Driver Details

Title:

Forename:

Surname:

Date of Birth:

Occupation:

House Name/No.

Post Code:

Date they passed their driving test: (approx.)

Second Driver Accidents or Claims

Have they made a claim?

Second Driver Claim 1

Date of Claim:

Type of Claim:

Brief Circumstances of Claim:

Do they have any additional claims?

Claim 2

Date of 2nd Claim:

Type of 2nd Claim:

Brief Circumstances of 2nd Claim:

Second Driver Motoring Convictions

Have they any previous motoring convictions?

Second Driver Conviction 1

Date of Conviction:

No. of Points Held:

Conviction Code:

Conviction Fine Amount:

Do you have any additional convictions?

Second Driver Conviction 2

Date of Conviction: