If you require an adjustment to your policy please fill out and submit the form below:

To help us process your adjustment as quickly and smoothly as possible, please answer all of the questions below and click the submit button. We will aim to contact you within two working days.


  Section 1 - About the person submitting the adjustment
     
1.

Broker Name

     
2.

Email address

     
3.

Contact name

     
4.

Telephone number

     
5.

Your reference

 


Section 2 - About the policyholder
     
6.

Policy number

     
7.

Policy name

8.

Specification number (if applicable)

 
Section 3 - Adjustment details
     
9.

What is the effective date of the
adjustment?

10.

Do you want to change the policy name?

Yes No
11.

Do you want to delete a property?

Yes No
12.

Do you wish to add or amend an insured
property?

Yes Amend No
13.

Additional Comments

Please note that this notification does not commit the insurer to accepting an increase in risk.
   


T: 01303-241170 | E:info@stephenlower.co.uk | F: 01303-850653