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Contact Details

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Title *
First name *
Surname *
Date of birth *
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House name or number
If you cannot find your address via the lookup please enter your address in manually.
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If you cannot find your address via the lookup please enter your address in manually.
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Address 2 *
Address 3 *
Address 4 *
Contact email address *
Telephone number *
Additional telephone number

Your Details

Have you been resident since birth? *
When did you become a UK resident? *
If you were not born in the UK, please tell us the date you started living in the UK.
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If you were not born in the UK, please tell us the date you started living in the UK.
Marital status *
What type of driving licence do you currently hold? *
When did you gain this driving licence? *
Driving licence number (optional)
What is your main employment status? *
Select Your Main Occupation *
Main occupation *
Industry of main occupation *
Industry of main occupation
How long have you held your taxi badge *
Are you a part time Taxi Driver? *
Industry of other occupation *
Do you have another employment status? *
Other occupation *
Industry of other occupation *
Number of Years Taxi Experience *
Have you had your Taxi, PHV or PSV licence, badge or permit revoked or been disciplined? *
Do you use a Ride-Hailing app? *
Enter yes if you are registered with Uber, Lyft or equivalent
?
Enter yes if you are registered with Uber, Lyft or equivalent
Are you a member of any motoring organisations? *
Do you have any DVLA-reported medical conditions or disabilities? *
If you are unsure if you need to tell the DVLA about a medical condition or disability, it is best you check directly with the DVLA.
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If you are unsure if you need to tell the DVLA about a medical condition or disability, it is best you check directly with the DVLA.
Do you own or use other vehicle *
Have you had or caused any accidents, claims or damage involving any motor vehicle in the past 5 years? *
A maximum of 5 incidents can be entered online, if you have more than 5 please tell us about these when we speak to you.
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A maximum of 5 incidents can be entered online, if you have more than 5 please tell us about these when we speak to you.
Have you had any motor related convictions, fixed penalties, or disqualifications in the past 5 years? *
A maximum of 5 motoring convictions can be entered online, if you have more than 5 please tell us about these when we speak to you.
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A maximum of 5 motoring convictions can be entered online, if you have more than 5 please tell us about these when we speak to you.
Do you have any unspent non-motoring convictions? *
Have you ever had insurance declined, cancelled or special terms imposed? *
This is where insurers have cancelled your policy or declined to continue with your policy or demanded special terms in your policy. This does not include situations where you have cancelled your insurance policy.
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This is where insurers have cancelled your policy or declined to continue with your policy or demanded special terms in your policy. This does not include situations where you have cancelled your insurance policy.
Have you ever been declared bankrupt or subject to an Individual Voluntary Arrangement (IVA) or had a CCJ within the last 10 years? *
Have you been a director of a company that has gone into liquidation or dissolved within the last ten years? *
Have you been disqualified from acting as a company director for any period of time? *
Are you a homeowner? *

Can We Help?

If you're having duffculties or not sure about something then call the team on

01268 916916

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XYZ Insurance is an independent intermediary who are authorised and regulated by the financial conduct authority(FCA).(Registration no:495468)