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Policyholder check form

Complete this form if you wish to verify your insurance policy

If you wish to check policy details for yourself, please complete Section C only.

If you wish to check the policy details for another party, please complete Section A or B (as appropriate) in addition to Section C.

* It is important that you provide as much information as possible. The more information you are able to provide, the quicker Lloyd's will be able to process your enquiry.

SECTION A

If you are a representative of a policyholder, do you have authorisation to make this enquiry on their behalf and are you permitted to receive information from Lloyd's about their policy?

If yes, please provide evidence of your authority to regulatoryrisk@lloyds.com or fax to +44 (0)20 7327 5988

SECTION B

SECTION C - We will not be able to assist with your enquiry unless you provide your contact details

Your full name

Your address

Your email address

Your telephone number

Please enter your enquiry here

Policy Details

Name of insured (if different from above)

Insured's address (if different from above)

Insured's email address

Insured's telephone

Class of business

Policy period

Policy number

Policy Document

Please confirm if you have received documents relating to your policy

If yes, please email a copy to regulatoryrisk@lloyds.com or fax to +44 (0)20 7327 5988

If possible, please provide the contact details of the person or company through which the policy was arranged.

Broker/Agent full name

Broker/Agent address

Broker/Agent email address

Broker/Agent telephone

Broker/Agent fax

If you know the name of the London based Lloyd's broker or Lloyd's syndicate, please provide details below.

Name

Syndicate number

Other parties

Have you contacted any other parties to verify the insurance?

If yes, please provide details

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Policyholder check form