1. Your details

• Your policy will be active from

  Choose an alternative start date
  Choose your start date*

• Postcode*

  Find your address by searching your postcode

  Find Address
  Postcode not found, please enter address manually
• Choose your address or type manually Select
• Address line 1*
• Address line 2 (optional)
• Town or city
• Title* Select your title from the list Mr Mrs Miss Ms Dr Other

• Please enter your desired title

• Forename*
• Surname*
• Your telephone number*

  For our records only, this will never be shared

• Mobile (optional)
• Email address*

  To send your confirmation email & policy documents

• Offer Code

  (enter all offer codes except direct mail promo codes)

• Owner

    Please confirm that you own and live in the property

• Guest house

    Please confirm this property is not a guest house or bed and breakfast

2. Your Boiler

• Boiler Brand* Please select Alpha Ariston ATAG Baxi Potterton British Gas Glow Worm Ideal Intergas Main Pro combi boilers Remeha Vaillant Viessman Vokera Worcester
• Boiler Model

  (Start typing and choose from list. If the model isn't there, please leave blank)

• Boiler age*

  (enter approximate age if unsure)

  Please select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

  Your monthly premium has increased by £2 as your boiler is 7 years or older.
• How many boilers do you have?* Please select 1 More than 1
• 
  Boiler Condition and Fuel Type*

    Please confirm your boiler operates on mains natural gas and is not currently in need of repair.

  
  
• Your property type*
  House
  Flat
  
  
  

3. Payment

CORGI HomePlan is a member of the Direct Debit Guarantee Scheme. Read More

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Direct Debit instructions

Instructions to your Bank or Building Society. Please pay CORGI HomePlan Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with CORGI HomePlan Ltd and, if so, details will be passed electronically to my Bank or Building Society.

Direct Debit Guarantee

• This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
• If there are any changes to the amount, date of frequency of your Direct Debit (insert your organisation name) will notify you (insert number of) working days in advance of your account being debited or as otherwise agreed. If you request (insert your organisiation name) to collect a payment, confirmation of the amount and date will be given to you at the time of request.
• If an error is made in the payment of your Direct Debit, by CORGI HomePlan Ltd or by your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society.
• If you receive a refund you are not entitled to, you must pay it back when CORGI HomePlan Ltd asks you to.
• You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

• Name of Account Holder*
• Bank Account Number*
• Bank Sort Code*