Agency Allianz - Franck Haloche

Agency Allianz - Franck Haloche

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Home insuranceHome Insurance Form

To receive a quotation for Home Insurance, please fill in the following details and click SEND. We will then respond to you as soon as possible.

 
Full Name:
 
Date of Birth: dd/mm/yyyy
 
Telephone:
 
Email Address:
 
Address of Property (to be insured)  
Owner or Tenant?  
Main Residence?  
Is the building less than 10 years old?  
Your occupation:  
Names & dates of birth of those who will be living in the property:  
     
Number & Size of Furnished Rooms:
(Please provide a plan if more than 6)

The policy is quoted in accordance with the number of furnished rooms. This does not include rooms less than 9 m² or kitchen, bathroom, toilets.
Please let us know their respective uses and internal measurements
 
Please provide a plan if more than 6 rooms:  
     
Outbuildings:
eg. barn, garage not connected to the main building

Please provide external measurements in Metres.
 
     
Value of Contents (without valuables):  Euros
 
Valuables: (Please calculate value very carefully)
 Euros
 
What are Valuables? Jewellery, gems, natural pearls, cultured pearls and solid precious metal objects, each with a value above €300. Furniture with a unit value above €8,000. Collections or sets with an aggregate value higher than €16,000  
Do you need only to cover jewellery, gems etc.. with a value above €300?  
     
Do you have a wood stove or a fireplace with a closed hearth?  
If so do you have the invoice of the installation?  
Do you have fire detectors?  
     
Do you need to be covered in case of theft?    
Inside your house and outbuildings?  
Theft of personal belongings outside your house
(mobile phone, luggage, leisure equipment)
 
     
Do you need to be covered for Glass breakage?    
For accidental damage to glass doors, windows, panel of electrical appliance and stove, veranda  
For accidental damage inside and outside your house  
     
Do you need the assistance cover?    
Following a claim (loss of keys, for example)  
For your family (to look after your ill children,
to replace your house employee)
 
For house works (for diagnosis, for example)  
     
Do you need electrical appliance?  
Do you have alternative energy?  
Do you have a swimming-pool?  
     
Do you need breakdown cover?    
For electrical appliances  
For TV, hi-fi, DVD player  
For a computer  
     
Do you want New for Old?  
     
Do you need legal assistance?  
     
How did you hear about us?  
     
Discount Code:  
     
Quotation in French only?  
     
 
 
Please call us on 0033 (0)2 43 05 21 82 if you have any problem with this form
     
   
     

 

Agency Allianz - Franck Haloche

1 rue Louis Blériot
Parc d’activités des Sémondières
53500 ERNEE
France


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Tel: 0033 (0)2 43 05 21 82
EMail: 4005417@agents.allianz.fr