Dentist Surgery Insurance
Complete the short form below to get a quotation or call 01473 269443
| Renewal Details | |||
| Renewal Date | Renewal Premium | ||
| Customer Details | |||
| Clients Name | Trading Name | ||
| Telephone Number | |||
| Building Name/Number | Postode | ||
| Risk Address if different from Above | |||
| How many years has the practice been trading | |||
| Property Details | |||
| Has the buildings fixed electrical wiring system been inspected and tested in the last 5 years |
Has a fire risk assessment of the building been carried out by a competent person in the last year |
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Is Property Standard Construction
 |
If No provide full details of construction |
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| Does the property have a flat roof | If yes please select percentage | ||
| Is Property Listed | If yes what Grade Listed | ||
| Sums Insured | |||
| Buildings (Rebuild Cost) | Tenants Improvements | ||
| Contents (excluding computers) | Computer equipment value | ||
| what value of contents is on fixed equipment | Stock | ||
| Annual Gross Fee Income of practice | |||
| Claims Experiance | |||
| Have you made any claims within the last 3 years | Number of claims made | ||
| If yes please provide details of claims below | |||
| Claim Type | Date Of Claim | Payments made | |
| Security | |||
| Do you have key operated window locks on all accessible opening windows fan lights & sky lights | |||
| Do you have BS3621 5 lever mortice deadlock on all entrance & final exit doors | |||
| In their and intruder alarm at the risk address | If yes is it maintained under an annual contract | ||
| Name of alarm company | NSI or SSAIB accredited | ||
| What is the intruder alarm signalling meathod |
Please select all that apply |
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| Are the premises protected by Local Authority CCTV | If other additional security measures please describe them in the box provided | ||
| Important Note | |||
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Any quote provided would be based on the following assumptions - 1) the property is not unoccupied for more than 21 consecutive days in any year; 2) the property is solely occupied by you as a dental surgery; 3) the property is not being in an area where flood, subsidence, heave or landslip are a problem now or have been in the past; 4) there are no large trees within 4 metres of the property; 5) there are no rivers within a close proximity of the property and 6) low pressure hot water, fixed gas or electrical appliances. |
If you can not agree to the important note please provide details. | ||
| Optional Covers | |||
| Terrorism | Practice Overheads | ||
| Professional Indemnity for dental nurses | Engineering Inspection | ||
| How Did you hear about us | |||