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Quotation Request

Eversure Cycle Insurance

Your Details
Your Cycles
Your Claims
Your Cover
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Note: Remember to save changes and 'Update Rates' in the Matrix tab to apply any discounts or endorsements you have applied.
Internal Discount %
Copy value from Internal Discount' field in Matrix tab
Apply Voucher Code
Code must match a valid code from lookup table
Apply Endorsement
Selecting 'Yes' will display endorsement section on policy documents. Remember to add the endorsement to the policy!
Apply Underwriter Load
This will apply any additional load requested by underwriters - must be a %
Allow Automatic Claims Loading?
Select 'No' to override rating file claims load

Your Details

Home Address
Date of Birth
Mobile Number
Home Telephone
Your Eversure Account

Do not edit - Source
Do not edit - Source Detail
Do not edit - Web Journey ID

Your Cycles

About Your Bicycles

Please list each of your bicycles for their current replacement value.

In order for cover to apply, you must follow the security and approved lock requirements for each of your cycles.

Cycle TypeMake and ModelFrame Number (optional)Cycle ValueLock RequiredExcess
Add row
Remove Highest Multi-Item Discount
Legal Expenses Cover
Cycle Breakdown

What are your cycles used for? (select all that apply)

Your cycles are automatically covered for leisure use.
Competitions & Events

Your Claims

Please list details of your previous claims below
AmountDateDate of ClaimClaim Type
Add row

Your Cover

When would you like your cover to start?
You can select a date up to 30 days ahead.

Eligibility Criteria

  1. You have read and accept the Policy Wording, Product Information Document, Terms of Business and Privacy Policy.
  2. All cycles being insured are in full working order and you can provide evidence of ownership.
  3. You have read and agree to the security and approved lock requirements.
  4. The cycles are only accessible to the insured, immediate family and friends at the insured location.
  5. You will exercise all reasonable precautions for the safety of the insured property.
  6. Your primary residence is in the UK (England, Scotland, Wales and Northern Ireland).
  7. You have never had insurance cancelled, declined or refused or any special terms imposed.
  8. You have never been declared bankrupt or, if you have, this has now been discharged.
  9. You have no unspent criminal convictions or police cautions within the last 5 years or have any prosecutions pending.

If you can no longer agree to one or more of these assumptions, either before commencement or during the term of the policy, then you shall notify Eversure Insurance immediately. Failure to notify us of any changes to these assumptions could invalidate your insurance.

I agree that the above assumptions are correct.
Please explain why you are not able to agree to the above declarations

Automatic Renewal

Your policy will automatically renew at the expiry of this policy period, subject to payment being received within 14 days of the renewal date. We will contact you prior to your renewal date with your new price and inform you of any changes. You can stop your automatic renewal at any time by contacting us.

Stay In Touch

Every now and then, we would like to share our latest products and promotions with you. Please let us know how you would like us to contact you by ticking below (select all that apply).


Rate Version
Documents Version
V6 = UKG last V10 = Collinson start V20 = Collinson v2 V21 = Collinson v2.1 (schedule only) V22 = UK options
Policy Holder Age
Renewal Count
Highest Value Cycle
Voucher Code %
Voucher Code Start Date
Voucher Code End Date
Voucher Code Valid?
Postcode Classification

Loading Calcs

Policy Holder Age Factor
Postcode Rating Factor
Cycle Use Factor
Worldwide Factor
Renewal Count Factor
Total Bike Premium
Total of Bike Rating Factors
Cycle Accessories Cover
Replacement Bike Cover
Personal Accident Cover
Public Liability Cover
Legal Expenses Cover
Cycle Breakdown