Household Insurance

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Information about the subscriber

- Title


First name (required)


Last name (required)

-Your Email (required)


Telephone (required)


Date of birth (required) dd/mm/yyyy

Information about the premises to be insured

-Address (required) :

-Town where premises are located (required) :

-Town ZIP Code (required) :

Quality ?

If rented ?

Type of premises ?

Do you occupy premises ?

Are the premises left unattended more than 60 days/year (in total)?

-Number of rooms* (required) :


Total surface (M²) including garage and cellar(required) :

*Not including bathrooms or kitchen but each room larger than 30m² counts double

Buildings :

-Contents sum insured in Euros (required) :


Valuable items in Euros :

On the property to insure, do you have ?

Floor ?

Have you had any claims last two years ?

Additional information

(type your message bellow) :

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Please send me a free, no obligation, quotation based on the above :