Commercial Vehicle Insurance Quote

Information You Must Disclose

The terms of any insurance that we arrange on your behalf will be based upon the information provided by you.

You must disclose all ‘Material Circumstances’ to us or your insurers, both at the outset and throughout the period of insurance cover. Material Circumstances are all the items of information that may influence the insurer’s decision as to whether to provide cover for your risk, the premium to be charged, and the terms of your insurance.

To identify what must be disclosed, you are required to carry out a reasonable search of your business and its activities.

As part of the search, you should consult with all senior management. This includes anyone who plays a significant role in the making of decisions regarding your business, regardless of whether that individual is a member of your board or is formally in a management role. This might include people such as site managers, risk managers, operational and business leaders. You will need to consider where to draw the line given the management of your business.

The most serious consequence of failing to disclose material information could be the invalidation of your cover. In this instance it would mean that a claim will be rejected.

The following must be disclosed:

• Claims and loss history
• Losses or incidents where claims were not made
• Criminal (non-motoring) Convictions
• Significant adverse credit history such as a CCJ
• Previous declinature by insurers to provide cover

  During the lifetime of the policy, you must notify us immediately of any changes in circumstance which may increase the possibility of loss, damage or legal liability covered by this policy.

  This list is not exhaustive and if you are in doubt as to whether any change in your circumstances need to be notified to insurers then please contact us with the details as soon as possible.

• Information You Must Disclose*
  I confirm I have read and understood the ‘Information You Must Disclose’

• General Details

• Your Name*
  First Last
• Phone Number
• Email Address*
• Company Name
• Business Type;
  Sole TraderLimited CompanyPartnership
• Please describe the nature of your business.
• Correspondence Address
  Address Line 1* Address Line 2 Town / City* Postcode*
• When do you need the insurance to start from?
  DD slash MM slash YYYY

• Vehicle Details

• What is your vehicle going to be used for?
  For example transporting music equipment / commuting / getting to contract sites

• Vehicle Registration	Make	Model	Value	Year of Registration	Gross Vehicle Weight (Kg)

• What is the address of where your vehicle is kept overnight?
  Property Number / Name Street / Road City / Town Postal Code
• Please describe where the vehicle is kept overnight.
• Where is the vehicle kept overnight?
  On a Residential RoadIn a Locked GarageOn a DrivewayIn a Car ParkOther
• What is the annual mileage?
• How many years No Claims Bonus have you had?
• What level of cover do you require?
  ComprehensiveThird Party & TheftThird Party Only
• Does the vehicle have any modifications or sign writing?
  • Yes
  • No
• Is your vehicle imported?
  • Yes
  • No
• Do you carry any hazardous, waste or dangerous goods?
  This includes carriage of fuel.
  • Yes
  • No
• Please specify what hazardous goods you are carrying.
• Do you need to add on another vehicle to the quotation?
  • Yes
  • No

• Vehicle Registration	Make	Model	Value	Year of Registration	Gross Vehicle Weight (Kg)

• Are both vehicles kept overnight at the same address as written above?
  • Yes
  • No
• Please specify the overnight address for the second vehicle.
  Name or Number Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country

• Driver Details

• What is your licence type?
  Full UK LicenceAutomatic OnlyInternationalOther
• What date did you obtain your driving licence?
  DD slash MM slash YYYY
• What is your Date of Birth?
  DD slash MM slash YYYY
• Have you had any motoring offences in the past 5 years?
  • Yes
  • No
• What was the motoring offence?
  SpeedingUsing your phone while drivingThird ChoiceFailing to stop at a red lightNot wearing a seat beltDriving without a MOTDriving without InsuranceDriving under the influence of alcohol or drugsOther
• Please specify the motoring offence if not listed?
• What was the date of the offence?
  DD slash MM slash YYYY
• Have you had any criminal convictions in the last 5 years?
  • Yes
  • No
• Has the business had any motor insurance claims in the past 5 years?
  • Yes
  • No
• Do you need to add on additional drivers?
  • Yes
  • No
• How many people in total will be using the vehicle?
  12345678910+
• How did you hear about CoverMarque - part of the Clear Group?*
  Please SelectWeb SearchAt The Showman's ShowOnline DirectoryAdvertSocial MediaWord of MouthOther
• Online Directory*
  • The Showman's Show
  • Open Air Business
  • KITSHIFT
  • StandOut
• Advert*
  • StandOut
  • HEN Magazine
  • Open Air Magazine
• Social Media*
  • Facebook
  • LinkedIn
  • Twitter
  • Instagram
  • TikTok
• Other*
  Please confirm where you heard about CoverMarque - part of the Clear Group
• Your marketing preferences
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• Handling of data*
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