Car and Home Insurance Bereavement Form

All fields are required unless states as optional

Name of policyholder

Please enter the name of the policyholder

Date of passing

Please enter the date of passing

Policyholder's address

manually enter address

Address Line 1

Address Line 1 is missing

Address Line 2

Town

Town is missing

County

Postcode

Postcode is missing

Postcode is invalid

Executor's name

Please enter the name of the executor

Lead executor's address

manually enter address

Address Line 1

Address Line 1 is missing

Address Line 2

Town

Town is missing

County

Postcode

Postcode is missing

Postcode is invalid

Lead executor telephone number

Please enter the lead executor's telephone number

Please enter a valid telephone number

Title of spouse/partner (if applicable) (optional)

Name of spouse/partner (if applicable) (optional)

Date of birth of spouse/partner (if applicable) (optional)

Occupation of spouse/partner (if applicable) (optional)

Is probate required?

Please select either 'yes' or 'no'

All fields are required unless states as optional

Policy or customer number

What do you want to do with the car insurance policy?

If probate is required, where will the vehicle be kept? (optional)

Whose address is this and what is the relation? (optional)

How long will it be kept at this address? (optional)

All fields are required unless states as optional

Policy or customer number

What do you want to do with the home insurance policy?

Is the property occupied or unoccupied? (optional)

If unoccupied, what date did the property become unoccupied? (optional)

Will buildings and contents cover continue? (optional)

If unoccupied, is the property checked weekly? (optional)

If so, what is the relationship of the person checking the property? (optional)

What is happening with the property in the future? (optional)

If occupied, who is living at the property? (optional)

What is the occupant's date of birth? (optional)

What is the occupant's occupation? (optional)

How long have they resided at the property? (optional)

How long will they remain at the property? (optional)

Does the occupant have any criminal convictions or County court judgements? (optional)

Has the occupant had an insurance policy cancelled in the last 5 years? (optional)

Has the occupant made any home insurance claims in the last 5 years? (optional)

If you have answered all the questions, click submit

Please verify

Bereavement service
car and home insurance form

Car insurance

Home insurance

Bereavement service car and home insurance form

Car insurance

Home insurance

Bereavement service
car and home insurance form