Unless all material facts are disclosed, this insurance could be invalidated.
Material facts are those facts an Insurer would regard as likely to influence
the acceptance and/or assessment of the proposal. If you are in any doubt about
whether facts are material, you should disclose them.
A copy of the completed Proposal form will be supplied on request but you should
keep a record (including copies of letters) of all information supplied to us
for the purpose of entering into this contract.
A specimen policy is available on request.
Please write in block capitals or tick the boxes as appropriate.