ICRIS Insurance

Motor Insurance

Please be advised that we can only offer quotations for insurance within mainland UK.

The quote form below is tailored specifically for UK Car Insurance and covers yourself.

If you require your quote now or have any problems completing the form, call us on the number below.

We can only provide quotes for residents of the mainland United Kingdom (we cannot provide quotes for residents of Northern Ireland or USA). Quotes issued can only be for insurance cover starting within the next 30 days.

01474 359756	9:00 - 5:30 Mon - Fri
	9:00 - 1:00pm Saturday

PERSONAL DETAILS

Title
Forenames
Surname
Address	Please Note: We can only provide quotes for residents of the mainland UK (we cannot provide quotes for residents of Northern Ireland).
Postcode
Date of Birth
Marital Status
Occupation
Employer's Business
Employment Status
Licence Type	Number of years held
Do you have a pass plus certificate
Are you a smoker
How many years have you lived in the UK
Do you have a credit card
Do you own your own home
How many years have you lived at the above address

VEHICLE DETAILS

Manufacturer
Make
Model
Have any modifications been undertaken
Date of registration	and/or Registration Plate
Is vehicle "Q" plated
Value of vehicle
Gearbox
Number of doors
Number of seats
Engine cc
Where is you car parked overnight
Who is the owner of the vehicle
Who is the main user of the vehicle
To what extent is the vehicle used
Do you have access to any other vehicles
Do you own any other vehicles
Does your vehicle have an alarm / immobiliser
Drive side

COVER DETAILS

Date cover required from	Quotes can only be provided for cover starting within the next 30 days.
Type of cover
Cover required for
Type of use
Number of years No Claims Bonus (NCB) (Number of years you have held car insurance in your own name and have not claimed for any accidents, fires or thefts.)
If you have 4 years or over NCB, would you like to protect it
Annual mileage
Have you ever had company car insurance and been claim free
Number of cars in household
Present Insurer (if known)
If you have already been given a quote please state the amount

ADDITIONAL NAMED DRIVER'S DETAILS

Title
Forenames
Surname
Relationship to proposer
Date of Birth
Marital Status
Occupation
Employer's Business
Employment Status
Licence type	Number of years held
Smoker
How many years have you lived in the UK

CONVICTIONS/DECLARATION

Have you or the above named driver had any convictions/endorsements/disqualifications/pending prosecutions during the last 5 years or any drink/drugs related offences within the last 11 years.
Have you or the above named driver made any claims for accidents or losses in the last 5 years.
Do you or the named above driver have any disabilities.
Have you or the above named driver ever been refused insurance


CONTACT INFORMATION

Please enter your email address
If we need to speak to you please indicate the best time to call
Please enter your preferred contact telephone number

*We will contact you within 48 hours of receipt of your enquiry. If you fail to receive the quotation within this time-scale, please contact Daniel Green on 01474 359756.*

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John Rice Associates Limited trading as Icris Insurance Services Gravesend is authorised and regulated by the Financial Services Authority

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