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Cornish Insurance
126-128 High Street,
Delabole, Cornwall
PL33 9AJ

Telephone:
01840 213836

Fax:
01840 212610

Email:
info@cornishinsurance.co.uk


Specialists since 1984
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UK-EuroVan Quote Form

Before completing this form please read the underwriting notes and conditions of acceptance to ensure the cover is adequate for your business activities. These rates are heavily discounted due to the tight underwriting we impose upon acceptance. Should your activities fall outside of these conditions of acceptance please call one of our specialist advisors for a quotation by telephone.

Conditions of Acceptance

  • You are not involved in any Courier Work or Multi-Drop deliveries (See Below*) and you have not entered into a service partnership agreement with either DHL, FedEx, TNT, APC, UPS, UK Mail Ltd and City Link Ltd (*)
  • You have never been declined motor insurance or had a policy cancelled
  • No driver has any prosecutions pending
  • No driver has sustained a serious motoring conviction in the past 5 years of any of the following: manslaughter, causing death by dangerous driving, driving under the influence of drink or drugs, failing to stop after an accident and any offence leading to a suspension from driving
  • All drivers have held a full UK/European licence for 60 months
  • The vehicle has not been modified from the manufacturers’ standard specification
  • No driver is suffering from any mental or physical disability that requires notification to the DVLA
  • All vehicles are registered in the UK
  • All vehicles are built to UK Specification
  • No vehicle is used for ‘airside’ work
  • The Carriage of goods of a corrosive, toxic, explosive or inflammable nature excluding classes 1 and 7 represents no more than 5% of your annual freight charges
  • No vehicle is used to carry abnormal, indivisible loads

*Courier Work/Multi-Drop  would be considered as more than 5 separate deliveries in a 24 Hour period for a consecutive period of 3 or more days. Should further clarification be required us on 01840 213836


  • All drivers must have held a full UK/European licence for a minimum of 5 years and have no more than 6 penalty points or ban within the last 5 years
  • All Drivers are over the age of 30 and under the age of 66
  • All Drivers are UK nationals and domicile within the UK
  • No Driver has had more than one fault accident within the last 3 years.  If you are in any doubt as to what may constitute a fault accident then please list any incident that has given rise to a claim within the last 3 years in the claims area provided below
  • No Driver has had a fire or theft loss within the last 3 years

Personal Information

First Name:*
Surname:*
Address:
Town:
County:
Postcode:
Company Name:
Business Type:
Telephone:*
Email:*
Website:

Your Vehicle Details

  Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4
Make:
Model:
Gross Vehicle Weight:
Year First Registered:
Value:
Registration Number:
No Claims Bonus Years:
Annual Green Card Required:
Can you limit your green card to Benelux countries only (Belgium, France, Luxemburg, Holland):
If this is a new start/venture are you able to supply a letter of claim free driving from a previous employer? Yes No
If so detail number of years you can provide:

You & Your Drivers

This policy is limited to named drivers aged 30 and over and 65 and below with 6 or less penalty points. If driving can be limited to one named driver only please tick here:
  Surname Forename Date of Birth HGV Licence List here any convictions sustained within the last 3 years inc dates and points received
Driver 1
Driver 2
Driver 3
Driver 4
Driver 5
Driver 6
Driver 7
Driver 8
Please provide details of any accidents sustained by any driver during the past 3 years.  Please include the drivers name, date of accident, fault or non fault and the costs if known: