Allcare Insurance Agency Ltd University Roundabout
Msida MSD 1751 Malta

Tel: (356) 21 330011
Fax: (356) 21 347947/8
 

HOME INSURANCE QUOTATION FORM

Name
*
Address for Correspondence
 
Postcode
 
Tel. No. / Mobile No.
*
Fax. No.
 
E-mail Address
*
Address of property to be insured
*

Is the property to be insured a:
Maisonette Apartment Terraced House Villa

Is the property alarmed and is the alarm regularly serviced ?
Yes No

Is the property left unoccupied for more than 90 consecutive days ?
Yes No
If yes, kindly indicate period of unoccupancy.

Would you like a quote to cover your Buildings?
Yes No
If yes, please state rebuilding cost.

Would you like a quote to cover your Contents ?
Yes No
If yes, please state the replacement value of your contents.

Would you like a quote for specified valuables on an All Risks basis ?
Yes No
If yes, please state the total amount you need to insure under this section.

Please indicate the area of cover required between
Maltese Islands Europe Worldwide

Do you have a motor policy already insured with us or directly with Middlesea Insurance plc or Citadel Insurance plc?
Yes No
Kindly quote policy number.

Have you ever suffered any loss or damage to your Home within these last 4 years?:
Yes
No
(If yes please provide details):

DATA PROTECTION

Insofar as the information that you provide us with in this form constitutes personal data for the purposes of the Data Protection Act 2001, Allcare Insurance Agency Limited will only process this information in the manner and for the purposes laid down in its Privacy Policy. By completing this form and clicking on the ‘Submit’ button below, you consent to Allcare Insurance Agency Limited processing this information in accordance with this Policy. Please view our Privacy Policy before submitting this form.