Request quote for home insurance in France

France Insurance / Request quote for home insurance in France

Last name

First name

Nationality

Birthdate

DD/MM/YYYY

Gender

Male

Female

What is your marital status ? *

Occupation

E-mail *

Phone *

Fax

Address

City

Zipcode

How did you hear about us ?

A particular question / comment ?

What type of home are you insuring ? *

Is it your principal residence ? *

Yes

What is the occupancy status of this home ? *

Owner

Co-owner

Renter

Address to be insured *

What are the total square meters of the home ? *

Did you file for a Claim for the last 3 years ? *

Yes

Is it a furnished home ? *

Yes

How many stories (excluding basement) are there ? *

For appartment within buildings, on which floor do you live ?

How many main rooms do you have ? (excl. kitchen & bathroom) *

How many rooms are more than 30 M2 ? If any, please specify how big

How many rooms, if any, are dedicated for professional use ?

How many bedrooms ? *

How many living rooms ? *

How much do you estimate the value of your belongings ? (amount in euros) *

(swimming pool, antiques, arts, jewels, horse, pets…etc.)

Please specify particular belongings to insure with total value in euros

When was your property built ? (approximatly) *

Choice of Benefits

Coverage without theft

Coverage inclusiv theft

Is your property wood heated ? (stove, insert...etc.) *

Yes

If yes, please specify if installed by a professionnal *

Yes

Do you have a veranda ?

Yes

How many days per year are you not living in this property ? *

Less than 90 days

Between 90 and 180 days

More than 180 days

Have you already received a cancellation notice for home insurance in the last 24 months ? *

Yes

Date of entry in the property

I have read and agree to the privacy policy *

Yes

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