1
PROPOSER INFORMATION
2
VEHICLE INFORMATION
3
POLICY INFORMATION
4
DRIVER INFORMATION
5
DECLARATIONS
6
CONTACT INFORMATION
PROPOSER INFORMATION
Proposers name
(Required)
Title
Dr
Miss
Mr
Mrs
Ms
Prof.
Rev.
First
Last
Proposers home address lookup
(Required)
Type your postcode or street we'll look up your address automatically
ZIP / Postal Code
Address details
(Required)
Street Address
Address Line 2
Town / City
Postcode
VEHICLE INFORMATION
Select your motorhome
Over cab bed
motorhomes
Low-profile coach built
motorhomes
A-class
motorhomes
Fixed roof
campervans
Rising roof
campervans
High-top
campervans
RV American motorhomes
up to 8500cc
T2 - T2 bay - T25 - New T2
Bay or Pre 1992 campervans
Race Truck CC
up to 3000cc
Vehicle registration
(Required)
Date of Registration
(Required)
Month
Day
Year
Vehicle value (not including satellites or personal effects)
(Required)
The approximate current market value of the vehicle, not the original price paid.
Vehicle make
(Required)
Vehicle model
(Required)
Engine size
(Required)
Number of seats
(Required)
0
1
2
3
4
5
6
7
8
9
Is the vehicle an import?
(Required)
Yes
No
Is the vehicle a left hand drive?
(Required)
Yes
No
Where is the vehicle normally parked overnight?
(Required)
Off-road parking other than the proposer's driveway or garage should be entered as 'Road'.
Locked Garage
Private Driveway
Road
Storage
Is the vehicle fitted with any security devices?
(Required)
None
Factory Fitted
Thatcham 1
Thatcham 2
Thatcham 2 - 1 Upgrade
Is the vehicle fitted with a tracking device?
(Required)
No Tracker
Category 5 Tracker
Category 6 Tracker
Thatcham VTS Tracking Device
Please select the vehicle's annual mileage band
(Required)
0-1.5k
1.5k-4k
4k-6k
6k-8k
8k-10k
10k+
Is there a parking sensor or reversing camera fitted?
(Required)
Yes
No
Currently, does the proposer personally have access to vehicles other than this vehicle?
(Required)
Yes
No
Is the vehicle privately converted?
(Required)
Privately converted is where the person or people carrying out the conversion are not registered as a business.
Yes
No
We can not accept home or privately converted vehicles during conversion - we can only accept such vehicles once the conversion is complete.
Please refer any vehicle conversion you are unsure meet our policy requirements.
Converted vehicles must have the following:
at least one bed with a minimum length of 6 feet or 180cm; this can be converted at night from seats used for other purposes during the day but must be permanently fixed within the body of the vehicle
permanently enclosed storage, i.e. wardrobe(s), cupboard(s) or locker(s)
a permanent fixed water installation connected to a fixed water storage tank or container
seating arrangements for diners to sit at a table (the table may be detachable but must have permanent means of attachment to the vehicle)
a sketch showing the floor plan of the vehicle's interior
fixed cooking or heating facilities powered by gas or electricity (the installation must have an engineer's report and/or electricity and gas certification)
proof of registration as a motorcaravan with the DVLA and have updated V5c
a door that provides access to the living accommodation
At least one window on each side of the habitation part of the vehicle
Photographic evidence is required as follows:
one photo showing the front and one of the sides with the number plate in full view
a second photo showing the rear and the other side of the vehicle (again clearly showing the number plate)
five photographs of the inside showing all parts of the conversion; the photos must show the cooker, sink and a rock n roll bed.
A copy of a gas and/or habitational certificate and a copy of the V5 with the vehicle registered to the DVLA as a motorcaravan.
Ensure that you have photographic evidence of the conversion before inception, as they might be requested as part of an audit trail or in case of a claim.
Vehicles not registered as motorhome/motorcaravan can be considered case-by-case but will require photographic evidence for the underwriter to make a decision.
Assumptions made about the vehicle
(Required)
- The proposed vehicle has not been modified in any way
- The vehicle has not been classified as an insurance 'write off'
- The vehicle is not registered as a Q plate
- The proposer is the owner and registered keeper of the vehicle
- The vehicle has a valid MOT certificate (unless not required due to the age of the vehicle) & current UK road fund license
I agree
I do not agree
POLICY INFORMATION
When would you need your policy to start?
(Required)
Today
Tomorrow
Other
Cover start date
(Required)
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
Year
2024
2023
What is the level of cover required?
(Required)
Comprehensive
Third Party, Fire & Theft
Third Party Only
Is the proposer a member of an Owner's club
(Required)
Any member of any motorhome or campervan club will receive a discount on the cost of the insurance (clubs included magazines and online clubs)
Yes
No
How is the vehicle used?
(Required)
Social, Domestic and Pleasure covers the drivers named on the policy for everyday driving, e.g. hopping, visiting friends or family, going to the park or on holiday. It does not include commuting to work.
SD&P + Commuting covers the above and driving to and from a permanent place of work.
Class 1 business allows you to drive to other work-related sites using your vehicle. It does not include commercial, e.g. deliveries or door-to-door selling.
Social Domestic & Pleasure
SD&P + Commuting
Class 1 Business Use
Does the proposer have any No Claims Discount to use on this vehicle?
(Required)
The proposer's no-claims bonus has to have been earned on a UK Vehicle, Motorhome or Van policy in consecutive years with the latest policy expiring within 2 years of the new policy starting.
0
1
2
3
4
5
6
7
8
9
DRIVER INFORMATION
Please provide us details of all drivers
You must include the proposer; any additional drivers must be between 17 and 85 years old.
DECLARATIONS
The policyholder and all the proposed drivers have not been convicted of any non-motoring convictions e.g. theft, drugs, dishonesty or fraud within the last 5 years
(Required)
I agree
I do not agree
The policyholder and all the proposed drivers have never been refused insurance or had a policy cancelled or void, renewal declined or special terms imposed
(Required)
I agree
I do not agree
The policyholder and all the proposed drivers have never been the subject of any County Court Judgement (CCJ) or Sheriff Court Decree.
(Required)
I agree
I do not agree
I agree that to the best of my knowledge and belief, all information given is true and complete, and I understand that Pedal Cover will rely on the information to accept the risk and calculate pricing.
(Required)
I agree
I do not agree
I understand non-disclosure or misrepresentation of any information may render an insurance policy void
(Required)
I agree
I do not agree
CONTACT INFORMATION
Contact email address
(Required)
Enter Email
Confirm Email
Mobile phone number
(Required)
Please enter a valid phone number.
Landline number
This is optional
I AGREE I AM HAPPY TO RECEIVE OTHER MARKETING MATERIAL BY EMAIL AND SMS INCLUDING THE PLAN INSURANCE BROKERS NEWSLETTER (YOU CAN OPT-OUT OF THESE MESSAGES AT ANY TIME)
(Required)
I agree
I do not agree
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The Old Mill, Ewenny, CF35 5BN
0800 121 4424
Lines Open Mon-Fri 9-5pm
enquiries@pedalcover.co.uk
