Policy Holder Details

Name :

Surname :

Email Address :

Telephone :

Full Spanish Address (Street house number, village, town, province) :

Postcode :



Description

Quality of the Home:

Constructed Area M2:

Location:

Use:

Use:

Year Constructed:

Year Renovated:

Type of Construction:


Security Measures

Bars on windows or similar
Reinforced Safety Door
Alarm connected to the safety switchboard
Security service in the urbanisation

Sum Insured

Building:

Contents:

Cosmetic Repairs Covered

Personal Liability Cover

Jewelry Kept in Safe:

Jewelry NOT kept in Safe:

Objects of Special Value:



Contracted Covers

Required Covers: BASIC COVERAGE, WATER DAMAGES, AESTHETIC REPAIRS, THEFT, BREAKAGE, LIABILITY, HOUSEHOLD ASSISTANCE

Covers linked to contents coverage. If you have chosen to cover only the building, unmark them to continue.

Travel Assistance
Computer Assistance

Optional Covers:

Legal Defense
Comprehensive Legal Defense
Household Appliance Breakdown
Accidental Damage
Accidents
Liability for Dangerous Dogs
Vehicles and Boats in the Garage

Form of Payment:

Effective Date: