Household/Let Property Flood Claim Form Please attach any photographs showing the external damage and any resultant internal damage, together with any invoices for emergency repairs or estimates for rectification (please don’t delay submission whilst waiting for an estimate) If you require any assistance in completing this form then please do not hesitate to contact the Claims Team on 01708 777710 between the hours of 9.00am and 5.30pm Monday to Friday. Please email the completed form and estimates (if available) to: . Alternatively post to us: Towergate Underwriting Claims, Towergate House, St Edwards Court, London Road, Romford Essex RM7 9QD. THIS FORM MUST BE FULLY COMPLETED, SIGNED AND DATED AND RETURNED WITH A COPY OF THE VALID PROPERTY POLICY SCHEDULE SECTION 1 DETAILS OF POLICYHOLDER AND POLICY – Policy No: Household Let Property scheme scheme Broker Policyholder - Title and Full Name Correspondence Address Address of Property Insured (if different) Postcode Postcode Email Address Contact Tel No: (If accessed regularly): (Between 9.00am Are you registered for VAT? Yes No 5.30pm) – SECTION 2 DETAILS OF WHEN, WHERE AND HOW LOSS/DAMAGE OCCURRED – Date of Loss/Damage Where did Loss/Damage occur? Who discovered it and when? State fully the description and cause of the Loss/Damage and how it occurred: (please provide a full explanation as to the cause and damage caused) Were the premises unoccupied at the time of the loss? Yes No If Yes, when were they last occupied? Were the premises furnished for normal occupation at the time of the loss? Yes No Were any refurbishments taking place at the property? Yes No SECTION 5 DAMAGE DETAILS OF CLAIM – – Estimated full cost of Estimated full cost of £ £ repair - buildings repair - contents Please attach your estimates to this claim form N.B If you are still awaiting estimates sending us this completed form and a copy of your don’t delay in valid Insurance schedule. If estimate(s) are being obtained and will be sent at a later date please tick the box ONLY EMERGENCY WORK TO PREVENT FURTHER LOSS MAY BE UNDERTAKEN. UNDER NO CIRCUMSTANCES SHOULD FULL REPAIRS BE CARRIED OUT WITHOUT UNDERWRITERS PRIOR CONSENT Has emergency work been carried out (e.g. to protect the property/prevent Yes No further damage) SECTION 6 NOMINATION – Do you wish to nominate another person to deal with the claim on your behalf? Yes No Nominee Name Address
Household/Let Property Flood Claim Form Please attach any photographs showing the external damage and any resultant internal damage, together with any invoices for emergency repairs or estimates for rectification (please don’t delay submission whilst waiting for an estimate) If you require any assistance in completing this form then please do not hesitate to contact the Claims Team on 01708 777710 between the hours of 9.00am and 5.30pm Monday to Friday. Please email the completed form and estimates (if available) to: . Alternatively post to us: Towergate Underwriting Claims, Towergate House, St Edwards Court, London Road, Romford Essex RM7 9QD. THIS FORM MUST BE FULLY COMPLETED, SIGNED AND DATED AND RETURNED WITH A COPY OF THE VALID PROPERTY POLICY SCHEDULE SECTION 1 – DETAILS OF POLICYHOLDER AND POLICY Policy No: Household scheme Let Property scheme Broker Policyholder - Title and Full Name Correspondence Address Address of Property Insured (if different) Postcode Postcode Contact Tel No: (Between 9.00am – 5.30pm) Email Address (If accessed regularly): Are you registered for VAT? Yes No SECTION 2 – DETAILS OF WHEN, WHERE AND HOW LOSS/DAMAGE OCCURRED Date of Loss/Damage Where did Loss/Damage occur? Who discovered it and when? State fully the description and cause of the Loss/Damage and how it occurred: (please provide a full explanation as to the cause and damage caused) Were the premises unoccupied at the time of the loss? Yes No If Yes, when were they last occupied? Were the premises furnished for normal occupation at the time of the loss? Yes No Were any refurbishments taking place at the property? Yes No SECTION 5 – DAMAGE – DETAILS OF CLAIM Estimated full cost of repair - buildings £ Estimated full cost of repair - contents £ Please attach your estimates to this claim form N.B If you are still awaiting estimates don’t delay in sending us this completed form and a copy of your valid Insurance schedule. If estimate(s) are being obtained and will be sent at a later date please tick the box ONLY EMERGENCY WORK TO PREVENT FURTHER LOSS MAY BE UNDERTAKEN. UNDER NO CIRCUMSTANCES SHOULD FULL REPAIRS BE CARRIED OUT WITHOUT UNDERWRITERS PRIOR CONSENT Has emergency work been carried out (e.g. to protect the property/prevent further damage) Yes No SECTION 6 – NOMINATION Do you wish to nominate another person to deal with the claim on your behalf? Yes No Nominee Name Address
household_let_property_claim_form.docx