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Declarations
The proposer or any drivers have never been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or insolvency proceedings, unless discharged.
The proposer or any drivers have never had a proposal refused or declined or ever had an insurance cancelled, renewal refused or had special terms imposed.
The proposer or any drivers do not have any non-motoring convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or have any prosecutions pending.
The proposer is domiciled in Great Britain, Northern Ireland, the Isle of Man, Jersey or Guernsey and is aged 18 years or older at the start date of this insurance.
The proposer agrees to their data being stored by Peliwica Insurance in line with their Privacy Policy, which can be read in full on the Peliwica website.
I hereby confirm that all the information provided on behalf of the proposer is accurate, and I understand that if I do not provide accurate information on behalf of the proposer, this may adversely impact the level of cover provided and any potential claims.
It is understood that there is no cover for assistance if the vehicle is being used for motor racing, rallies, rental, hire, public hire, private hire, self-drive hire, courier services or any contest or speed trial.
It is understood that there is no cover for any breakdown occurring within 24 hours of the policy starting or the policy being amended (i.e. a change of vehicle). This does not apply when renewing a policy (either renewing with Peliwica or switching from another provider at renewal).