CAR INSURANCE QUOTE FORM

MINIMUM QUOTE REQUIREMENTS

  • Over the age of 21
  • Minimum vehicle value: £50,000
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Date Of Birth
When purchased/leased date
Security at parking
Do you require protected no claims discount?
Date License Obtained
Any medical conditions reported to the DVLA?
Any accidents in the last 5 years?
Any motoring convictions in the last 5-years?
Have you or any person to be insured, ever had insurance declined, refused, cancelled or had special restrictions imposed?
Have you or any person to be insured, ever entered any arrangements with creditors or been declared bankrupt?
Have you or any person to be insured, ever been convicted of any unspent offence?
Do you want the quote to include any additional named drivers?
Do you believe there is any additional information we should know about in the presentation to insurers for terms?
We can also provide household insurance, which offers portfolio discount and access to additional motor products – would you like us to quote your household now or at renewal?

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GET IN TOUCH

For more information about how we can help or to get an insurance quote, contact our team today.

Contact Us
HEAD OFFICE

34 Lime Street,

Leadenhall,

London,

EC3M 7AT

CONTACT US

contact@john-clarkinsurance.co.uk

0203 808 9863

NAVIGATION
POLICIES
REGULATORY

John Clark Motor Insurance Services is a trading name of Provenance Insurance Brokers LTD who is authorised & regulated by the Financial Conduct Authority in respect of General Insurance business. Our firm’s reference number is 804047, which can be checked by visiting the FCA website.


A company registered in England and Wales Company Number: 11131702

FINANCIAL OMBUDSMAN SERVICE

Should you have cause to complain, and you are not satisfied with our response to your complaint, you may be able to refer it to the Financial Ombudsman Service, which can be contacted as follows: The Financial Ombudsman Service Exchange Tower, London, E14 9SR | Tel: 0800 023 4567 or 0300 123 9123 | www.financial-ombudsman.org.uk

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