To Activate your Free 14 day Insurance please complete the form below. Please note no cover exists until confirmed by ourselves in writing

About you

Title

- Select Item -

First Name*

Last Name*

Date of Birth*

January

2004

Property Name/No.*

Street Address

Town/City

County

Postcode*

Telephone*

Email*

Item

- Select Item -

Description

Value

Please insure for the full retail price of your item or current valuation, which ever is the greater.

Date you took delivery of the Item

Please note, cover will only start from the date you apply and must be within 7 days of the delivery of your item from the retailer

On effecting this cover we will provide 14 days Free insurance covering the following:

You must be over 21 years of Age
Cover only available for items up to £15,000
Items over £10,000 may have additional security requirements. Please refer to your policy schedule.

I am applying for the 14 Days Free insurance for my item of Jewellery, and I confirm the following:

I am a resident of the United Kingdom.
Whether insured or not, neither I, or any other person living with me, or anyone whose property is to be insured, have sustained any loss or damage during the last five years.
Neither I, or any other person named in the Schedule or anyone living in the households of the items to be insured have ever been convicted or charged with any offence (other than a motoring offence or any convictions which are spent under the Rehabilitation of Offenders Act 1974)
Neither I, or any person named on this insurance, or any company any person named on this insurance has controlled, has ever been declared bankrupt, or been the subject of any bankruptcy proceedings, county court judgment, individual voluntary arrangement or debt relief order.
Neither I, or any other person to whom this insurance applies, have ever had any insurer decline to accept, cancel, refuse to continue (or agree to continue only on special terms) any insurance policy.

If you are unable to confirm this declaration, please call our office on 0203 907 8080 as we may still be able to assist you.