ChauffeurPLAN: Insuring your motoring future
ChauffeurPLAN: Insuring your motoring future Longford Insurance Schemes
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Longford Insurance Schemes

Driving Licence Insurance - Individual / Joint Application

Thank you for choosing to protect your driving licence with Chauffeurplan. Please complete the application form below. If you require individual cover please complete all sections marked principle. Should you require full partner cover at half the normal premium please complete the sections marked partner as well.

If you are aged 21 or over and hold and have held a current, valid full UK driving licence for a period of at least 2 years cover is guaranteed.

Here you can find more information regarding which level of cover you may require.

Fields marked with an * are mandatory and must be completed in order to progress

Enter Principle's Details

Title Principle:

First Name Principle: *
Surname Principle: *
Date of Birth Principle:* Year: 19
Address 1: *
Address 2:
Town: *
County:
Postcode: *
Telephone (day): *
Telephone (day): *
Telephone (eve):
Email Address: *
Occupation Principle:
How did you hear about us

Enter Partner's Details

Title Partner:

First Name Partner:
Surname Partner:
Occupation Partner
Date of Birth Partner: Year: 19

Please tick below to confirm that you hold and have held a current, valid, full UK driving licence for a period of at least two years*

Principle *
Partner


Do you have any Penalty Points, current or pending, if so how many?*

Principle

Partner


Please choose the Level of Cover you require:*

Cover Plans
4 Star
3 Star
2 Star
1 Star

Principle

Includes 5% discount

£284.05

£153.90

£116.85

£79.80

Partner

Includes 50% discount

£142.03

£76.95

£58.43

£39.90

I/we hereby apply for Chauffeurplan cover as indicated above. I/we are aged 21 or over, hold and have held a current valid full UK driving licence for a period of at least 2 years and are aware of the maximum points restrictions. I/we agree to be bound by the cover of our choice and the rules of Chauffeurplan from time to time in force. Payment of any claims will be made only after receipt by Longford Insurance Schemes of the full premium or any outstanding balance thereof. I/we declare that the information given in this form is correct. I understand and give consent that the information I provide about myself and, if applicable, my partner will be passed to or used by Isle of Man Assurance Ltd and its agents and subcontractors and Longford Insurance Schemes for and in connection with my insurance. This includes underwriting, processing, claims handling and fraud. No claims can be accepted where the offence, injury or incident occurred prior to the start date of the policy.

† CONDITIONS: Chauffeurplan cover applies while driving any car you are legally entitled to drive. Cover does not apply to motorcycles. Cover for Car Hire and Emergency Travel is conditional on the incident being the subject of a Motor Insurance claim and does not apply as a result of fire, mechanical fault or breakdown. Chauffeurplan does not cover disqualification imposed as a direct result of drink or drugs related offences or reckless, dangerous, careless or inconsiderate driving. In order to be covered for “totting up" disqualification benefits you must have no more than 7 points on your licence actual, possible and/or pending when you apply . However, when the penalty points are down to 7 with no prosecutions possible or pending you will then automatically be covered against disqualification following the totting up of future penalty points. Cover is not available to taxi or minicab drivers.

I have read, understand and accept the terms and conditions of the policy. *
From time to time Longford Insurance Schemes may write to you with details of offers that may be of interest to you. If you would like to hear from us please tick the box.