Dance Teachers Insurance

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1 Dance Teachers Insurance Policy information and proposal form Royal Academy of Dance Insurance scheme available to members and authorised personnel based in the UK

2 Policy information As a member or authorised personnel of the Royal Academy of Dance, and while carrying out your business as a Teacher, Adjudicator, Examiner, Lecturer, Tutor, Mentor, Practical Teaching Supervisor and/or Dance School Principal within the United Kingdom, you are entitled to the protection of a package of covers designed specifically for your needs by the Association s insurance broker, Gallagher Heath Insurance Services and underwritten by AXA Insurance plc. Authorised personnel are those acting in the capacity of Adjudicator, Lecturer, Tutor or Practical Teaching Supervisor on behalf of Royal Academy of Dance.

3 What you need to do Please read the policy information, choose your optional covers and complete the proposal form at the end of this leaflet. When you have completed this application form, return it to the address provided with a cheque for the appropriate amount, payable to Gallagher Heath Insurance Services. Cover will start as soon as this application form and premium have been received and accepted by Gallagher Heath Insurance Services. You will then be issued with an Employers Liability Certificate, schedule and policy wording. The Dance Teachers Insurance automatically includes all dance teaching activities including keep fit, aerobics, drama and pilates. However cover for special performances must be agreed with us in writing. Policy limits This is a summary of certain limits provided by the policy and does not contain all the inner limits or the full terms and conditions of your insurance. You can find the full terms and conditions of the product in the policy wording, a copy of which is available from Gallagher Heath on request. This policy information is provided to you for information purposes only and does not form part of your insurance contract. The Liability insurance sections are compulsory. You must purchase this cover if you wish to purchase other sections of cover. Helpline The Dance Teachers insurance includes a helpline number You can use this number to access a 24 hour emergency legal helpline to ensure there is someone to help you when you need it most. You can also use this number for a tax / health and safety advice line available Monday to Friday between the hours of 9am 5pm. Employers liability section (compulsory) Insurance protection in respect of legal liability for bodily injury to employees. Employers liability Manslaughter costs Safety legislation costs Terrorist act Limit of indemnity 10,000,000 any one occurrence 1,000,000 any one period of insurance 1,000,000 any one period of insurance 5,000,000 any one occurrence

4 Public and products liability section (compulsory) Insurance protection in respect of legal liability for injury to third parties or for damage to their property. Limit of indemnity Public liability Products liability Clean up costs Data protection Manslaughter costs Safety legislation costs Terrorist act 5,000,000 any one event 5,000,000 any one period of insurance 100,000 any one period of insurance 250,000 any one period of insurance 1,000,000 any one period of insurance 1,000,000 any one period of insurance 5,000,000 any one period of insurance Cover includes shows and performances in venues (i) with a viewing audience capacity of up to 500 people, or (ii) not involving the hiring of lighting equipment and/or operation of such equipment, or the use of pyrotechnics, or the use of seating that is not permanently fixed to the premises. Please contact Gallagher Heath Insurance Services prior to the event and with full details, if you require us to consider cover for a show or performance that is not covered in the above description. Financial loss liability section (compulsory) Insurance protection against legal liability for third party financial loss arising out of a defect in or the unsuitability of products or services. Financial loss Limit of indemnity 25,000 any one period of insurance Excess 500 Selected all risks section (optional) An All risks cover to protect specific items in the United Kingdom. Maximum value 15,000 covered anywhere in the United Kingdom. Description Fixed property including mirrors, ballet barres and dance floors whether fixed or otherwise Computer equipment All other property Excess 35 of each and every loss, increased to 70 in respect of theft from business premises, not involving entry or exit by forcible and violent means

5 Business interruption section (optional) Insurance cover to protect your business income following damage to your business premises. Description Sum insured Indemnity period Cover Gross revenue Additional cost of working Amount you select, maximum 50, months All risks 10, months All risks Gross revenue sum insured: This is the total annual income provided from the details entered on this proposal form. Money and personal accident assault section (optional) An All risks cover to protect business money. Cash limit 500 ( 15 excess). Personal accident assault See Table of compensations within the policy wording. Personal accident section (optional) Cover for accidental injury to principals, teachers, employees and, optionally, for students. Choose from the following options when completing the proposal form. Insured persons category: Principals, Teachers, Employees. Student benefit is 15,000 (other than death for under 16 year olds is 5,000) and excludes temporary disablement. Options Benefits Death, loss of eyes or limbs 15,000 30,000 60,000 90,000 Permanent total disablement 15,000 30,000 60,000 90,000 Temporary total disablement* Temporary partial disablement* *Up to 104 weeks excluding the first 14 days

6 Operative time 24 hours each day in respect of each insured person described under Categories A, B and C in your schedule. Only while an insured person described under Category D in your schedule is participating in dance tuition organised in connection with the business anywhere within the policy territories. Accumulation Limit Aircraft accumulation 200,000 Event accumulation 500,000 Cancellation period This policy is annually renewable and the premiums quoted are for 12 months. You have a right to cancel the policy within 14 days. Full details can be found in the policy wording, a copy of which is available on request. Law applicable condition You and we can choose the law which applies to this policy. We propose that the Law of England and Wales apply unless we and you agree otherwise, the Law of England and Wales will apply to this policy. Making a complaint If you have a complaint about your policy you should contact the agent or AXA office where it was bought. If your complaint relates to a claim on your policy please contact the department dealing with your claim. If we have given you our final response and you are still not satisfied you may be eligible to refer your case to the Financial Ombudsman Service (FOS). If applicable, you will receive details of how to do this at the appropriate stage of the complaints process.

7 Financial Services Compensation Scheme (FSCS) AXA Insurance is covered by the Financial Services Compensation Scheme (FSCS). You may be entitled to compensation from the scheme in the unlikely event we cannot meet our obligations to you. This depends on the type of insurance and the circumstances of the claim. Further information about the compensation scheme arrangements is available from the FSCS (www.fscs.org.uk). The Insurance brokers advising on the scheme are: Gallagher Heath Insurance Services, AMP House, 9th Floor, Dingwall Road, Croydon CR0 2LX Telephone: Gallagher Heath Insurance Services is a trading name of Heath Lambert Limited which is authorised and regulated by the Financial Conduct Authority. Registration number Registered Office: The Walbrook Building, 25 Walbrook, London EC4N 8AW. Registered No: The Royal Academy of Dance are an Introducer Appointed Representative of Heath Lambert Ltd. Insurers of the scheme are: AXA Insurance UK plc Registered in England and Wales No Registered Office: 5 Old Broad Street, London EC2N 1AD. A member of the AXA Group of companies. AXA Insurance UK plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. FCA number Telephone calls may be monitored and recorded.

8 Proposal form Other information you need to disclose 1: Have you ever been involved in any incident which has or may result in a claim, within the last 5 years under the Sections you are proposing for insurance? Yes / No If Yes, please provide details 2: Has any insurer declined to insure you, imposed special terms, cancelled or refused to renew your insurance or declared cover void? Yes / No If Yes, please provide details 3: Do you teach full-time professional dancers? Yes / No If Yes, please provide details 4. Is there any other relevant information you should tell us? 5: Please provide your Employee Reference Number (where applicable) The information you have provided It is essential that all the information you have provided is full and true, and that it includes all relevant information, because this information will form the basis of the insurance contract between you and us. By relevant information, we mean information that could affect our decision to give you insurance or affect the terms we give you. If you are not sure whether something is a relevant information, please tell us anyway. Please note: The information we base your insurance contract on may include s, letters, phone calls or other communications from you or your adviser, as well as your adviser s presentation. Please keep a record of all information given to us (including copies of letters or s). If you do not disclose all relevant information, or if you fail to give full and true answers to any of the questions on this form, your policy will not protect you. Before signing the Declaration, please read the following Data Protection notice. Data Protection AXA Insurance UK plc is a member of the AXA Group. In order to supply your quote and then to administer your insurance policy, we will hold and use information including sensitive personal data and claims information you provide and may send it in confidence for secure processing to other companies in the AXA Group (or companies acting on our instructions) including those located outside the European Economic Area. Sharing information and making checks We may share information which we hold and which has been supplied to us in connection with any application for insurance that you have made, or any insurance policy which you have with us (including the renewal of any policy which you have with us) with the Claims and Underwriting Exchange register, run by the Insurance Database Services Limited (IDS Ltd) and other similar databases or fraud prevention agencies established for the same purpose. The aim is to help us check information that is given to us and to prevent fraudulent claims. When we process your request for insurance cover, we may search these registers. We may also make credit reference checks. Under the conditions of your policy, you must tell us about any incident (such as an accident or theft), whether or not you think it is likely to give rise to a claim. When you tell us about an incident, we will pass information relating to that incident to these registers. Employers Liability Tracing Office (ELTO) If your policy provides Employers Liability cover information relating to your insurance policy will be provided to the Employers Liability Tracing Office (the ELTO) and added to an electronic database, in a format set out by the Employer s Liability Insurance: Disclosure by Insurers Instrument Your signature Please read this declaration carefully and then sign below. If there is more than one proposer, a person who is authorised to sign on behalf of all proposers should sign the declaration. I confirm that I am the person authorised to sign this form on behalf of all proposers. I agree that the information provided and this declaration together form the basis of the contract between the proposer and AXA Insurance UK plc. I agree to accept the terms and conditions of the AXA Insurance UK plc policy applicable to this proposal. I understand that all relevant information, which is information that may influence AXA Insurance UK plc in the acceptance of this insurance and the terms provided, has been disclosed and recorded. I declare that all particulars given whether made by or on behalf of the proposer are true and complete. I understand that if full and true answers have not been given or if all relevant information has not been disclosed that this insurance will not protect the proposer in the event of a claim. Before the start date of the contract, I will tell you about any changes to the details already given, or about any new information that may affect how AXA Insurance UK plc considers this proposal. I confirm that I, or any organisations that our partners or directors have been involved with (as a partner or director), or any of our partners or directors in a personal capacity have never: been declared bankrupt, been the subject of any bankruptcy proceedings or any form of insolvency or winding up procedures (including administrative receivership) been convicted of a criminal offence other than a motoring offence, or charged (but not yet tried) with a criminal offence other than a motoring offence been the subject of a recovery action by HM Revenue & Customs been prosecuted, served prohibition or served an improvement order under Health and Safety legislation been disqualified from being a company director. Signature Date Name Position in your organisation Please note: until Gallagher Heath have confirmed that this proposal has been accepted, you are NOT insured under this policy. POST THIS APPLICATION Detach and post this application to: Gallagher Heath Insurance Services, AMP House, 9th Floor, Dingwall Road, Croydon, CR0 2LX. Together with a cheque (payable to Gallagher Heath Insurance Services ) for the total premium due.

9 Proposal form Name(s) Business description Postal address Business address (if different from above) Membership ID I/We apply for cover as below: Liability - compulsory Contact tel no Postcode Postcode Premiums are based on the maximum number of teachers teaching at any one time. Please select below as appropriate. Premium Premium 1 Teacher to 5 Teachers Over 5 Teachers Premium on application To increase public liability limit of indemnity to 10,000,000 - contact Gallagher Heath Insurance Services Optional sections * Please delete as appropriate Selected all risks (optional) Cover required Yes / No* Item Sum insured (value as new) Rate Fixed property including mirrors, ballet barres and dance floors 1.29% Computer equipment 5.17% All other property 2.07% Minimum premium for this section Business interruption (optional) Cover required Yes / No* Total annual income amount Rate 0.26% Minimum premium for this section Money (optional) Cover required Yes / No* Fixed premium Personal accident: Principals,Teachers and Employees (optional) Cover required: Yes / No * Please refer to the Personal accident section in the Policy information Benefit cover level options Rate per person Please complete details below Category Number Benefit option premium from table above Principals Teachers Employees Accident pupil (optional) Cover required Yes / No* Number of pupils 0.52 per pupil 0.52 Minimum premium for this section Total premium Premiums / rates include 9.5% Insurance Premium Tax.

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