Broker Application

Company Details

Company Name:
Address:
City:
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Post Code:
Website:
Landline Phone No:
Fax Number:

Contact Details

Title:
Forenames:
Surname:
Contact phone number:
Alternative contact number:
Position:
Company email address:

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Free Trial

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You will not be charged for any QuoteRack leads supplied to you during your Free Trial period.

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Lead Selection

All currently available categories of lead and the price of each lead are listed below. If you don't see the category of lead that you require please let us know in the comments box provided.

Please select the types of lead that you wish to receive by placing a tick in the appropriate boxes (your selections can be changed at any time, subject to availability).

N.B. Please be aware that categories marked as 'Unavailable' can still be selected but you will be placed on a waiting list.

Business
Cost
  • Agriculture insurance
    		•  Unavailable
  • Alarm installers liability insurance
    		•  $8.00
  • Architects liability insurance
    		•  $8.00
  • Arts and crafts insurance
    		•  $6.00
  • Aviation insurance
    		•  Unavailable
  • Bed and breakfast insurance
    		•  $8.00
  • Blocks of flats insurance
    		•  $8.00
  • Business interruption insurance
    		•  Unavailable
  • Business liability insurance
    		•  $8.00
  • Care home insurance
    		•  $8.00
  • Charity insurance
    		•  $6.00
  • Chip shop / takeaway insurance
    		•  $8.00
  • Commercial property flood insurance
    		•  $8.00
  • Commercial property insurance
    		•  $8.00
  • Crop insurance
    		•  Unavailable
  • Cyber liability insurance
    		•  $8.00
  • Directors and officers insurance
    		•  $8.00
  • Dog groomer insurance
    		•  $7.00
  • Door supervisors / security guard insurance
    		•  $8.00
  • Drillers insurance
    		•  Unavailable
  • Earthmovers insurance
    		•  Unavailable
  • Electricians public liability insurance
    		•  $20.00
  • Emergency services insurance
    		•  Unavailable
  • Entertainers insurance
    		•  $6.00
  • Entertainment insurance
    		•  $6.00
  • Farm Insurance
    		•  $8.00
  • Financial advisors professional indemnity
    		•  $8.00
  • Fire brigade insurance
    		•  Unavailable
  • Firework display insurance
    		•  $1.00
  • Fitness instructor and personal trainer insurance
    		•  $6.00
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $15.00
  • Goods in transit/hauliers liability insurance
    		•  $7.00
  • Hazardous materials / toxic waste insurance
    		•  $8.00
  • HGV and haulage insurance
    		•  $8.00
  • Hotel and guest house insurance
    		•  $8.00
  • Internet and Ebay Business Insurance
    		•  $6.00
  • Landlords insurance
    		•  $8.00
  • Leisure industry
    		•  $6.00
  • Licensed trade - bars, clubs and off-licences
    		•  $8.00
  • Manufacturing insurance
    		•  $8.00
  • Marine, freight and cargo insurance
    		•  $8.00
  • Medical malpractice insurance
    		•  $20.00
  • Miners insurance
    		•  Unavailable
  • Motor trade insurance - part-time
    		•  $5.00
  • Motor trade insurance - road risks
    		•  $8.00
  • Motor trade insurance - with business premises
    		•  $10.00
  • Multiple events insurance (Annual Policy)
    		•  $1.00
  • Music event liability insurance
    		•  $1.00
  • Musicians insurance
    		•  $6.00
  • Nightclubs, casinos and adult clubs
    		•  $8.00
  • Office insurance
    		•  $8.00
  • One-off event or show insurance
    		•  $1.00
  • Performing artists
    		•  $6.00
  • Plumbers public liability insurance
    		•  $20.00
  • Private investigators insurance
    		•  $6.00
  • Professional indemnity insurance
    		•  $8.00
  • Pub insurance
    		•  $8.00
  • Restaurant insurance
    		•  $8.00
  • Roofers and scaffolders insurance
    		•  $8.00
  • Salon insurance
    		•  $8.00
  • Security companies
    		•  $8.00
  • Serviced office insurance
    		•  $6.00
  • Shop insurance
    		•  $8.00
  • Snooker, pool and billiard hall insurance
    		•  $8.00
  • Solicitors' insurance
    		•  $8.00
  • Sports club and association insurance
    		•  $8.00
  • Sports event insurance
    		•  $6.00
  • Surgery, clinic and practice insurance
    		•  $8.00
  • Tattoo liability insurance
    		•  $6.00
  • Taxi fleet insurance
    		•  $12.00
  • Taxi office business insurance
    		•  $8.00
  • Trade credit insurance
    		•  $20.00
  • Tradesmen insurance
    		•  $8.00
  • Traffic control insurance
    		•  $20.00
  • Vacant business premises insurance
    		•  $8.00
  • Van couriers insurance
    		•  $8.00
  • Waste management and recycling insurance
    		•  Unavailable
  • Wedding insurance
    		•  $1.00
  • Wholesale business insurance
    		•  $8.00
  • Working from home insurance
    		•  $8.00
    Car
    Cost
  • 4x4 car insurance
    		•  $6.00
  • Alpina car insurance
    		•  $6.00
  • American car insurance
    		•  $6.00
  • AMG car insurance
    		•  $6.00
  • Aston Martin car insurance
    		•  $6.00
  • Audi car insurance
    		•  $4.00
  • Bentley car insurance
    		•  $6.00
  • BMW car insurance
    		•  $6.00
  • Bugatti car insurance
    		•  $6.00
  • Car Insurance – standard risk vehicle / drivers
    		•  $6.00
  • Chauffeur hire insurance
    		•  $6.00
  • Classic car insurance
    		•  $6.00
  • Combined car and home insurance
    		•  $8.00
  • Company-owned car insurance
    		•  $6.00
  • Custom car insurance
    		•  $6.00
  • Disabled drivers' car insurance
    		•  $5.00
  • Drink-drive car insurance
    		•  $6.00
  • Drug-driving car insurance
    		• $6.00
  • Family fleet insurance
    		•  $6.00
  • Ferrari car insurance
    		•  $6.00
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $15.00
  • High risk occupation driver
    		•  $6.00
  • High value car insurance $100,000+
    		•  $6.00
  • Jaguar car insurance
    		•  $6.00
  • Lamborghini car insurance
    		•  $6.00
  • Land Rover car insurance
    		•  $6.00
  • Left hand drive car insurance
    		•  $5.00
  • Lotus car insurance
    		•  $6.00
  • Maserati car insurance
    		•  $6.00
  • McLaren car insurance
    		•  $6.00
  • Mercedes-Benz car insurance
    		•  $6.00
  • Minibus insurance
    		•  $6.00
  • Modified car insurance
    		•  $5.00
  • Motor trade insurance - part-time
    		•  $5.00
  • Motor trade insurance - road risks
    		•  $8.00
  • Noble car insurance
    		•  $6.00
  • Off-road 4x4 vehicle insurance
    		•  $5.00
  • Over 50's car insurance
    		•  $6.00
  • Private hire car insurance
    		•  $6.00
  • Range Rover car insurance
    		•  $6.00
  • Rolls-Royce car insurance
    		•  $6.00
  • Self-drive hire car insurance
    		•  $5.00
  • Taxi fleet insurance
    		•  $12.00
  • Taxi insurance
    		•  $6.00
  • TV / Film / Radio celebrity car insurance
    		•  $6.00
  • TVR car insurance
    		•  $6.00
  • Wedding hire car insurance
    		•  $6.00
  • Young driver (< 25) high performance car insurance
    		•  $5.00
  • Young driver (under 25 years old) car insurance
    		•  $5.00
    Challenge QuoteRack (Priced by category)
    Cost
  • Challenge QuoteRack
    		•  $0.00
    Emergency Services Insurance
    Cost
    Health
    Cost
  • Age 50+ health insurance
    		•  $20.00
  • Company health insurance schemes
    		•  $20.00
  • Leaving a company health insurance scheme
    		•  $20.00
  • Pre-existing condition health insurance
    		•  $20.00
  • Previous claims health insurance
    		•  $20.00
  • Private health insurance
    		•  $20.00
  • Serious illness cover
    		•  $20.00
    Home
    Cost
  • Adverse claims history home insurance
    		•  $5.00
  • Annexe and granny-flat insurance
    		•  $6.00
  • Barn conversion insurance
    		•  $6.00
  • Bed and breakfast insurance
    		•  $6.00
  • Blocks of flats insurance
    		•  $8.00
  • Buy-to-let and let property insurance
    		•  $6.00
  • Combined home and car insurance
    		•  $8.00
  • Converted property insurance
    		•  $6.00
  • Fine art, antiques and valuables insurance
    		•  $6.00
  • Flat insurance
    		•  $6.00
  • Flood risk home insurance
    		•  $6.00
  • Foster carers home insurance
    		•  $6.00
  • High value home insurance (high net worth)
    		•  $6.00
  • Holiday home insurance
    		•  $6.00
  • Homeowners buildings and/or contents insurance
    		• $6.00
  • Hotel and guest house insurance
    		•  $8.00
  • Landlords property and legal insurance
    		• $8.00
  • Non-standard construction home insurance
    		•  $6.00
  • Over 50's home insurance
    		•  $6.00
  • Property renovation insurance
    		•  $5.00
  • Self-build property insurance
    		•  $5.00
  • Solar panels home insurance
    		•  $6.00
  • Sportsman/woman home insurance
    		•  $6.00
  • Student possessions insurance
    		•  $5.00
  • Subsidence and underpinned property insurance
    		•  $6.00
  • Timber frame home insurance
    		•  $6.00
  • TV/film/radio celebrity property insurance
    		•  $6.00
  • Unoccupied home insurance
    		•  $6.00
  • Vacant business premises insurance
    		•  $8.00
  • Working from home insurance
    		•  $8.00
    Leisure
    Cost
  • Boat insurance - cruisers, narrowboats and barges
    		•  $3.00
  • Caravan park and campsite insurance
    		•  $6.00
  • Dinghy insurance - sailing, rowing and inflatables
    		•  $3.00
  • Jet-ski insurance
    		•  $2.00
  • Mobile home / static caravan insurance
    		•  $2.00
  • Sports club and association insurance
    		•  $8.00
  • Sports event insurance - amateur or professional
    		•  $4.00
  • Touring caravan insurance
    		•  $2.00
  • Trailer tent insurance
    		•  $2.00
  • VW camper van insurance
    		•  $4.00
  • Yacht insurance
    		•  $6.00
    Life
    Cost
  • Company director life insurance
    		•  $15.00
  • Company pension schemes
    		•  $15.00
  • Critical illness protection
    		• $15.00
  • Existing medical condition life insurance
    		•  $15.00
  • Family history life insurance
    		•  $15.00
  • Group income protection
    		•  $15.00
  • Group life insurance
    		•  $15.00
  • Hazardous pastimes life insurance
    		•  $15.00
  • High risk occupation life insurance
    		•  $15.00
  • High value life insurance cover
    		•  $15.00
  • Impaired life annuity
    		•  $15.00
  • Income protection insurance
    		•  $15.00
  • Key man life insurance
    		•  $15.00
  • Life insurance - standard
    		•  $15.00
  • Mortgage protection
    		•  $24.00
  • Non-standard mortgage protection
    		•  $24.00
  • Pensions and annuities
    		•  $15.00
  • Previously rejected for life insurance
    		•  $15.00
  • Serious illness cover
    		•  $15.00
  • Shareholder protection
    		•  $15.00
  • Term assurance
    		•  $15.00
    Bike
    Cost
  • Chopper insurance
    		•  $3.00
  • Classic motorbike insurance
    		•  $3.00
  • Cruiser and tourer motorbike insurance
    		•  $3.00
  • Ex-offenders motorbike insurance
    		•  $3.00
  • Grey / personal import motorbike insurance
    		•  $3.00
  • Mobility scooter insurance
    		•  $2.00
  • Modified motorbike insurance
    		•  $1.00
  • Motorbike insurance
    		•  $3.00
  • Poor driving record motorbike insurance
    		•  $2.00
  • Quadbike Insurance
    		•  $3.00
  • Rare or unlisted motorbike insurance
    		•  $1.00
  • Scooter & moped insurance
    		•  $2.00
  • Trike insurance
    		•  $3.00
  • Young rider motorbike insurance
    		•  $3.00
    Pet
    Cost
  • Horse and equestrian insurance
    		•  $3.00
  • Older pet insurance
    		•  $2.00
  • Pet insurance
    		•  $1.00
  • Unusual or rare breed pet insurance
    		•  $2.00
    Sports Event Insurance
    Cost
    Travel
    Cost
  • Annual travel insurance (multiple trips)
    		•  $3.00
  • Group travel insurance
    		•  $1.00
  • Hazardous or extreme sports travel insurance
    		•  $1.00
  • Over 60's travel insurance
    		•  $1.00
  • Pre-existing medical condition travel insurance
    		•  $1.00
  • Sportsmen travel insurance
    		• $2.00
  • Travel insurance - single trip
    		•  $2.00
  • Winter sports travel insurance
    		•  $1.00
    Van
    Cost
  • Courier and delivery driver van insurance
    		•  $8.00
  • Dog grooming van insurance
    		•  $6.00
  • Fire engine insurance
    		•  $4.00
  • Fleet motor insurance (2 - 5 vehicles)
    		•  $10.00
  • Fleet motor insurance (6+ vehicles)
    		•  $15.00
  • Goods in transit/hauliers liability insurance
    		•  $7.00
  • HGV and haulage insurance
    		•  $8.00
  • HGV fleet insurance
    		•  $15.00
  • Minibus insurance
    		•  $6.00
  • Mobile catering vans
    		•  $5.00
  • Modified van insurance
    		•  $5.00
  • Non-standard goods van insurance
    		•  $6.00
  • Non-standard or high-risk occupation van insurance
    		•  $6.00
  • Private ambulance insurance
    		•  $5.00
  • Private use van insurance
    		•  $6.00
  • Refrigerated van insurance
    		•  $6.00
  • Removal van insurance
    		•  $6.00
  • Scrap metal dealers van/truck insurance
    		•  $6.00
  • Self-Drive Hire Van Insurance
    		•  $5.00
  • Skip lorry insurance
    		•  $6.00
  • Tipper van insurance
    		•  $6.00
  • Truck fleet insurance
    		•  Unavailable
  • Truck insurance (more than 7.5 tonne GVW)
    		•  $6.00
  • Van insurance (less than 7.5 tonne GVW)
    		•  $6.00
  • VW camper van insurance
    		•  $4.00
  • Young driver (under 25 years old) van insurance
    		•  $5.00
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