Caravan Quotation
Wise Insurance Services Limited
168 Croydon Road
Beckenham
Kent
BR3 4DE

020 8663 3939

Please print the completed form before pressing the Enter key or clicking on the Submit form button.

DEALER DETAILS

Dealer number: Dealer name:

THE PROPOSER

Title:
First name: *
Surname: *
Date of birth: *
Telephone:
Email:
Occupation:
Address: *
*
 
Post code: *
   

CARAVAN DETAILS - Roma, Hobby, Lord Munsterland (LMC) and Tabbert caravans cannot be quoted for.

Make: *
Model: *
Year: *
Axle: Single: Twin:
Serial / Vin number: *
Stored when not in use: *
Caravan address: *
*
 
Caravan post code: *
Details if other:
If caravan not on home driveway, enter security details:
Security fencing: *
Type: *
Height (in feet): *
Locked gates: *
CCTV installed:
Security - Hitch lock & wheel clamp compulsory
Other security:
No. of caravans on site: *
Insurance start date: *

GENERAL QUESTIONS

1.
Will the caravan ever be used for towing on the road? *
2.
Have you had any accidents or losses during the last 3 years with any caravan owned, hired or used by you? *
If Yes, How many accidents: Total Value:
3.
In respect of a motor vehicle or caravan owned by you, has any insurer declined to accept, cancelled or refused to renew or applied special terms to your policy? *
4.
Have you or your spouse been subject to any declaration of bankruptcy or been convicted of, or charged but not yet tried, of any offence other than driving? *
(you do not have to disclose convictions regarded as 'spent' under the Rehabilitation of Offenders Act 1974)
5.
Is the caravan occupied as a permanent residence? *
6.
Will the caravan be let out on hire other than on a fixed site? *
7.
Will the caravan ever be used for business purposes? *
8.
Have you ever towed a caravan on the road before? *
(not applicable to Static Caravan Policies)
9.
If the caravan is kept on a caravan site or compound, has any caravan on the site or compound suffered damage by storm, flood, theft or vandals? *
10.
Do you require optional Awning cover? *
(New for Old for up to 7 years, Limit of Indemnity £2500 - only available for awnings under seven years old)

SUMS INSURED

Caravan: (once you enter this amount, all values below will be calculated automatically) * £
Equipment: (15% of the caravan sum insured included free of charge) £
Contents and personal effects: (10% of the caravan sum insured included free of charge) £
Total caravan sum insured: £
Awning sum insured: £
Premium: £

PAYMENT OPTIONS

Please contact us by post or telephone using the details at the top of the form. Office hours are: Monday to Friday 9:00am - 5:30pm, Saturday 9:00am - 1:00pm.

Payment can be made using one of the following methods:

  • In full.
  • Short term credit - pay a deposit of: £
    followed by 3 consecutive monthly payments of: £
  • By direct debit - 12 monthly payments of: £

PREMIUM PAYMENT

The premium can be paid:

By post - please send your remittance to us within 7 days, together with this signed form. All cheques to be made payable to Wise Insurance Services Ltd.

Credit card by telephone - please call with your details.

Direct debit by telephone - please call with your bank account number and sort code.
Signature: Date: