Fire insurance - 2023 - VDV Conseil - Assurances - Crédits immobiliers - Placements2023 – VDV Conseil – Assurances – Crédits immobiliers

Secure forms

*Required information

GENERAL INFORMATION

Surname
First name
Address and no.
Town
Postal code

Gender
Date of birth (dd/mm/yyyy)

Email
Telephone (home)*
Office telephone no.
Telephone (mobile)

Are you a Test-Achats member?
If yes, please state your membership number
Are you already a VDV CONSEIL PLC client?

Location and description of property to be insured

Is the risk address identical to that of the person taking out the insurance ?
If no, please provide the address (Street/Avenue, N°, Bte, Postal code,Town)

Is there a garage located at another address?
Please provide the address below (Street/Avenue, N°, Bte, Postal code,Town):

Do you?

If owner, do you want a waiver of recourse against the tenants?

Type of contruction
Building materials
If other technique or undifined :

Building age
If building with major renovation, thanks to precise kind of renovation :
Date of construction (New building) /Date of renovation

Is this a house or flat which serves as a secondary residence?
If it is a flat, thank you to specify the floor

Which is the name of the insurance company of the building's overall policy (co-ownership) ?
Appartment building: How many dwellings ?

Building assessment schedule (Building and/or content)

Please note that the grid below is not applicable for apartment buildings and / or investment houses.
Thank you for contacting our office for this kind of property. Description of rooms
Premises less than 4 m² must not be taken into account except for wet rooms

Living room
Dining room
Wet room (bath or shower) irrespective of the area
Attic
Converted attic
If attic converted, witch destination (bedroom, aso.)
Library
Veranda
Reception hall
Laundry
Please specify on which floor(s) of the house this room is located (basement, ground floor, 2nd floor etc.)
Boxroom
Please specify on which floor(s) of the house this room is located (basement, ground floor, 2nd floor etc.)
Garden shed
Garage (even if without direct access to the house)
Number of parking spaces for cars in this garage

Kitchen
Bedroom
Cellar
Office
Room for sewing, for ironing
Court ou private garden
Play room
Premises intended for the practice of a liberal profession
Boiler room
Please specify on which floor(s) of the house this room is located (basement, ground floor, 2nd floor etc.)
Workshop
Please specify on which floor(s) of the house this room is located (basement, ground floor, 2nd floor etc.)

Other (please specify):
Other : rooms
Other (please specify):
Other : rooms
Total area to be specified in m2

Other (please specify):
Other : rooms

Description of property

"Energy" criteria
Other criteria Hauteur de plafond supérieure à 3mPrésence d'une cuisine équipéePrésence de feu ouvert ou d’une cheminée décorative
Type de chauffage
Présence de revêtement de sol en

Presence in roof of
Presence of at least one room for residential purposes or the purposes of a liberal profession, the area of which exceeds 70 m²
Presence of solar panels (photovoltaic or thermal)
Presence of an outdoor swimming pool (other than inflatable)

Theft of contents

Would you like theft cover?
Would you like cover for theft of jewellery ?
Would you like cover for theft of valuables ?

Is the building equipped with the following preventive measures?

"Certified monitored alarm and mechanical guarding"
Certified non-monitored alarm
Armored door

Optional cover

Option garden
Option pool (extérieure)
Option business
(Insurance of goods and / or professional equipment in private dwelling)
Vehicle at rest
Number of vehicles:
Third Party Private Life
Family Plan

Home Legal Protection
Indirect losses
Legal Protection Private Life
Personal Assistance

Questions related to Natural Disasters

Has the building been subjected to flooding or overflow or backflow from public sewers in the last 5 years?

Number of claims

Please tick where applicable:
There was a single claim concerning the basement only (*)There was a single claim concerning the ground floor onlyThere were several claims involving the basement and/or ground floor (*)

Previous contract or history

Have you taken out a home insurance policy before ?

If yes: What was the insured risk address (street, no., postal code, town):
With what company?
Contract number:
Effective date
Maturity date:

Was this insurance cancelled or declined by another insurance company?

Has the insured risk been subjected to stabilisation measures? (For example: premium increase, excess adjustment)
Précisez (par exemple : augmentation de prime, adaptation de la franchise)

Have there been any accident claims in the last 5 years?
Date of accident claim:
If more than one claim, please specify in remarks

Outlay (amount of compensation):
Nature of claim:

Payment of premium

I would like to pay:

Comments if any:

This information is given on a confidential basis; you may however authorise us to use your e-mail address to be kept informed on developments and promotions at VDV Conseil.

No, I do not want to receive your news.Yes, I would like to receive your news.

*Required information

GENERAL INFORMATION

Location and description of property to be insured

Building assessment schedule (Building and/or content)

Description of property

Theft of contents

Is the building equipped with the following preventive measures?

Optional cover

Questions related to Natural Disasters

Has the building been subjected to flooding or overflow or backflow from public sewers in the last 5 years?

Please tick where applicable:

Previous contract or history

Payment of premium

Comments if any: