PROFESSIONAL INDEMNITY INSURANCE
|
|
- Frederick Lewis
- 8 years ago
- Views:
Transcription
1 BDB (UK) Limited 40 Lime Street, London EC3M 7AW PROFESSIONAL INDEMNITY INSURANCE INSURANCE CONSULTANTS & FINANCIAL ADVISERS PROPOSAL FORM 1
2 THIS PROPOSAL MUST BE SIGNED BY A PARTNER OR DIRECTOR OF THE BUSINESS. ALL QUESTIONS MUST BE ANSWERED AND ADDITIONAL INFORMATION PROVIDED WHEN REQUESTED TO ENABLE A QUOTATION TO BE GIVEN. THE COMPLETION AND SIGNATURE OF THIS PROPOSAL DOES NOT BIND THE PROPOSER OR THE COMPANY TO COMPLETE A CONTRACT OF INSURANCE PLEASE USE AN ADDITIONAL SHEET OF PAPER WHERE NECESSARY TO PROVIDE COMPLETE ANSWERS TO ALL QUESTIONS 1 Name(s) under which business is conducted 2 Date business established 3 Address and Website Address 4 If more than one office exists, is there a senior partner/director at each office to oversee operations? If NO please provide a curriculum vitae of the person overseeing each office 5 (a) Has the name of the business changed or have any mergers or acquisitions taken place during the past ten years? (b) Is cover required for the above predecessor firms? 2
3 6 Have the business activities changed substantially during the past ten years? 7 Please indicate the professional associations of which the business is a member FSA AIFA IIB BIBA Others (Please state) 8 Give details of all partners/directors Name Age Qualifications Date Qualified How Long Practising as a Partner/Director IF UNDER FIVE YEARS EXPERIENCE IN THIS OCCUPATION PLEASE SUPPLY A CURRICULUM VITAE 9 (a) Numbers of permanent staff (other than partners/directors in current business) Qualified All others (b) Does the Business have any Appointed Representatives? (c) Does the Business have any Self-Employed Consultants? If YES to (b) or (c), please provide full details on your headed paper. 3
4 10 Please give the total gross commission/fee income for the past two years and forthcoming year generated from LAST COMPLETE YEAR Year End / / PREVIOUS YEAR Year End / / FORTHCOMING YEAR Year End / / UK Overseas Total 11 Please give details of any insurances placed for clients resident outside of the UK 12 Please give details of any insurances placed with insurers or underwriters who do not operate in the UK or who are not members of the ABI or Lloyds 13 (a) In respect of fire and perils, please give details of the two largest Sums Insured that you place ie, the material damage and business interruption combined exposure Client Risk Sum Insured (b) In respect of public liability, products liability or professional indemnity risks, please give details of the two highest limits that you place Client Risk Sum Insured 4
5 14 Please specify the percentage of the business gross commission/brokerage/fees derived from the following: Pensions Endowments Other Life Mortgages Building Society Agencies PHI Medical Insurance Pension Fund Managers, Trustees or Administrators Private Client Portfolio Management Discretionary Investment in Unit Trusts or Insurance Bonds Dealing in Listed, Unlisted UK or Foreign Securities Dealing in Bonds (eg Eurodollar), or Commodities Investment in Tangibles (eg. Coins, Gems etc) Accountancy, Taxation Management Consultancy Mergers and Acquisitions/Corporate Finance Estate Agency Personal Lines Insurance (excluding Motor) Commercial Insurance (excluding Motor) Motor Insurance Construction Insurance Professional Indemnity Insurance Aviation/Marine Insurance Other (please specify) TOTAL 100% 15 For any of the categories in Question 15 is more than 50% of the business placed with one Insurer? If YES, please give details 16 Please give details of the other activities if applicable 5
6 17 Does the business operate any binding authority arrangement whereby an insurer or underwriter has granted the business authority to set rates terms and conditions and/or to handle claims without referral? If YES please complete the supplementary questionnaire 18 Please give details of the supervision procedures of junior staff (i.e., those with less than 2 years insurance experience) If not applicable please write N/A 19 (a) Has the business sustained any loss during the past ten years as a result of the fraud or dishonesty of any partner, director or employee of the business? (b) Is any individual authorised to sign cheques as a sole signatory on behalf of either the business or clients accounts?, specifying limit (c) How often are entries in cash books reconciled with bank statements by a partner/director or company secretary (other than the head cashier and/or chief bookkeeper)? Weekly Monthly Quarterly (d) (e) (f) Is there a complete annual audit by a firm of professional accountants? Are clients funds kept in properly designated clients accounts separate from the accounts of the business? Are satisfactory written references always obtained when engaging all new partners, directors, employees or self employed persons? If NO please advise why not 6
7 20 Please give details of the firm s professional indemnity insurance over the last three years Limit of Indemnity Insured s Contribution (Excess) Premium Name of Insurer Expiry Date of Policy 21 (a) What limit of indemnity is required? (b) What contribution (excess) do you wish to pay 22 In respect of professional indemnity insurance, has any insurer ever declined a proposal, declined to pay a claim, refused renewal, cancelled such insurance or imposed special conditions? 7
8 23 Claims History (a) Has any claim been made against the business or an employee of the business or any partner, director or consultant or their predecessors in business during the last ten years in respect of the type of liabilities to which this proposal relates? Date of Claim Brief Details Amount of Claims Paid Reserves Outstanding (b) Has any action been taken to prevent a recurrence of a claim? If NO why not? 8
9 (c) After enquiry, are any of the business partners or directors aware of any claim pending or any circumstance which might give rise to a claim against the business or any of the present or previous partners or directors of the business? (d) Have present insurers been notified of all claims including requests for a pension review and all circumstances, which may give rise to claims? If NO please give details (e) Have any disciplinary proceedings been brought by a regulatory or professional body against the business, any employee, self-employed consultant or any partner or director or their predecessors in business during the last ten years? 9
10 Important Reminder: All claims/complaints and circumstance (i.e. potential claims) must be immediately reported to your existing insurer prior to expiry of your current policy. Please advise any matters or circumstances which we might wish to take into account in determining whether to offer you insurance cover Declaration I/we declare that the above statements and particulars are true, full enquiry having been made, and I/we have not suppressed or mis-stated any material facts and undertake to inform the insurer of any change to any material fact I/we agree that this declaration together with any other information shall be the basis of any contract between me/us and the insurer Signature of Proposer (Partner/Director) Name For and on behalf of (Insert Name of Business/Firm) Date Please retain a copy of this completed proposal form for your records 10
PROFESSIONAL INDEMNITY INSURANCE
BDB (UK) Limited 40 Lime Street, London EC3M 7AW PROFESSIONAL INDEMNITY INSURANCE ACCOUNTANTS PROPOSAL FORM 1 GUIDANCE NOTES This proposal must be completed in ink by a Partner or Director of the Proposer.
More informationHow To Write A Professional Indemnity Insurance Plan
PROFESSIONAL INDEMNITY INSURANCE MISCELLANEOUS PROPOSAL FORM GUIDANCE TES This proposal must be completed in ink by a Partner or Director of the Proposer. Please use your headed notepaper to provide full
More informationProfessional indemnity insurance Insurance brokers & IFA s proposal form
Professional indemnity insurance Insurance brokers & IFA s proposal form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block
More informationINDEPENDENT FINANCIAL ADVISORS PROFESSIONAL INDEMNITY PROPOSAL FORM
INDEPENDENT FINANCIAL ADVISORS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT NOTICE TO THE PROPOSER TO COMPLETION OF THIS PROPOSAL FORM 1) Disclosure - Any material fact must be disclosed to Insurers.
More informationProfessional indemnity insurance Mortgage brokers & IFA s proposal form
Professional indemnity insurance Mortgage brokers & IFA s proposal form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block letters
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR INSURANCE INTERMEDIARIES
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR INSURANCE INTERMEDIARIES Howden Insurance Brokers Limited is an official scheme provider of Professional Indemnity for BIBA members Please complete this
More informationINSURANCE BROKERS PROFESSIONAL INDEMNITY PROPOSAL FORM
INSURANCE BROKERS PROFESSIONAL INDEMNITY PROPOSAL FORM Centry Gothic Please read the following questions carefully and answer them all providing additional information where required. Should you require
More informationINSURANCE BROKER AND INTERMEDIARIES PROFESSIONAL INDEMNITY PROPOSAL FORM
INSURANCE BROKER AND INTERMEDIARIES PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT NOTICE TO THE PROPOSER TO COMPLETION OF THIS PROPOSAL FORM 1) Disclosure - Any material fact must be disclosed to Insurers.
More informationInsurance Broker and Intermediaries Professional Indemnity Proposal Form
Insurance Broker and Intermediaries Professional Indemnity Proposal Form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block
More informationPROFESSIONAL INDEMNITY INSURANCE INDEPENDENT FINANCIAL ADVISERS PROPOSAL FORM
PROFESSIONAL INDEMNITY INSURANCE INDEPENDENT FINANCIAL ADVISERS PROPOSAL FORM GUIDANCE NOTES This proposal must be completed in ink (or electronically) by a Principal, Partner or Director of the Proposer.
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM Please answer all questions fully and if you have a brochure or any other information concerning your business please attach to this proposal. 1. Name of
More informationI INSURANCE BROKERS PROPOSAL FORM PROFESSIONAL INDEMNITY
HCC International Walsingham House, 35 Seething Lane London EC3N 4AH, United Kingdom main +44 (0)20 7702 4700 facsimile +44 (0)20 7626 4820 I INSURANCE BROKERS PROPOSAL FORM PROFESSIONAL INDEMNITY IMPORTANT
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR INSURANCE INTERMEDIARIES
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR INSURANCE INTERMEDIARIES - 1 - P a g e CONTENTS 1. ADVICE ON COMPLETING THE PROPOSAL FORM 2. PROPOSAL FORM 3. BINDING AUTHORITY QUESTIONNAIRE 4. OTHER
More informationInsurance Brokers Professional Liability Proposal Form
Insurance Brokers Professional Liability Proposer Details 1. Name of Firm(s) 2. Principal address Postcode Tel No. Website 3. Date Firm Established 4. Please provide details of any subsidiary companies
More informationIMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM
Accountants Professional Indemnity Insurance Proposal Form IMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM Method of Completion This proposal form may be completed in ink or electronically and
More informationProfessional Indemnity Insurance for Insurance Brokers and Intermediaries
Professional Indemnity Insurance for Insurance Brokers and Intermediaries Proposal Form Important tice 1. This is a proposal for a contract of insurance, in which Proposer or you/your means the individual,
More informationProfessional Indemnity Insurance for Insurance Intermediaries Proposal Form
Professional Indemnity Insurance for Insurance Intermediaries Proposal Form Professional Indemnity Insurance for Insurance Intermediaries Proposal Form Please read the following carefully before completing
More informationPROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE ACCOUNTANTS
PROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE ACCOUNTANTS ACCOUNTANTS PROFESSIONAL INDEMNITY INSURANCE This proposal form must be completed in ink by a Partner, Principal or Director of the Firm or Company.
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ACCOUNTANTS
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ACCOUNTANTS This proposal form must be completed in black ink by a Partner, Principal or Director of the Company. All questions must be answered to enable
More informationAccountants. Professional Indemnity Proposal Form. Vantage Professional Risks. 41 Eastcheap London EC3M 1DT
Professional Indemnity Proposal Form Accountants Vantage Professional Risks 41 Eastcheap London EC3M 1DT Telephone 020 7655 8020 Email: pi@vantageinsurance.co.uk www.vantageprofessionalrisks.co.uk IMPORTANT
More informationProfessional Indemnity Insurance for Insurance Brokers
Professional Indemnity Insurance for Insurance Brokers Proposal Form Please complete, sign and return together with the attachments to: Affinity A division of Lockton Companies LLP The St Botolph Building
More informationTHIS APPLICATION IS FOR A CLAIMS MADE POLICY
PEMBROKE SYNDICATE 4000 ACTUARIES ERRORS AND OMISSIONS INSURANCE APPLICATION THIS APPLICATION IS FOR A CLAIMS MADE POLICY ALL QUESTIONS MUST BE ANSWERED COMPLETELY. DO NOT LEAVE ANY SPACE BLANK. INDICATE
More informationIMPORTANT POINTS. Please ensure all questions are answered fully, where there is insufficient space please supply information on a separate sheet.
IMPORTANT POINTS Please ensure all questions are answered fully, where there is insufficient space please supply information on a separate sheet. The questions must be answered to the best of your knowledge
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ACCOUNTANTS PLEASE READ THIS GUIDANCE NOTE BEFORE COMPLETING THE PROPOSAL FORM To help us to provide you with our most competitive quotation, it is important
More informationProfessional Indemnity Insurance Design and Construct Industry Proposal Form
Professional Indemnity Insurance Design and Construct Industry Proposal Form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block
More informationDIRECTORS & OFFICERS LIABILITY INSURANCE PROPOSAL FORM
BDB (UK) Limited 40 Lime Street, London EC3M 7AW DIRECTORS & OFFICERS LIABILITY INSURANCE PROPOSAL FORM 1 GUIDANCE NOTES This proposal must be completed in ink by a Partner or Director of the Proposer.
More informationAccountants Professional Liability Insurance Proposal
AIG Europe Limited Proposer Details Name of Firm(s) Principal Address line one Principal Address line two City and postcode Telephone number Fax number Website address Does the Firm(s) have any branch
More informationAccountants Professional Indemnity Insurance Proposal
Accountants Professional Indemnity Insurance Proposal AIG Europe Limited 30 North Wall Quay International Financial Services Centre Dublin 1 Proposer Details 1. Name(s) of Firm(s) 2. Nature of business
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM Please answer all questions fully and if you have a brochure or any other information concerning your business please attach to this proposal. 1. Name of
More informationSecurus Insurance Limited. Proposal Form. Accountants Professional Indemnity
Securus Insurance Limited Proposal Form Accountants Professional Indemnity Securus Insurance Limited Suite 3, Stafford House Strand Road Portmarnock Co Dublin Phone (01) 8464512 Fax (01) 8464522 Email
More informationProfessional Indemnity Insurance for Accountants. Proposal Form
Professional Indemnity Insurance for Accountants Proposal Form Professional Indemnity Insurance for Accountants Proposal Form Please read the following carefully before completing this proposal form. To
More informationAccountants Proposal Form
Accountants Proposal Form Proposal Form IMPORTANT: In this proposal: You / Your refers to all firms to be insured under this arrangement, including any predecessor or previous business for which cover
More informationProfessional Indemnity Proposal Form Business & Management Consultants
Professional Indemnity Proposal Form Business & Management Consultants This form does not apply to: IT Consultancy. Please see the IT Professions proposal form GUIDANCE NOTES Completing your proposal form
More informationCMS/CANOPIUS NEW BUSINESS PROPOSAL FORM 2010
1. Proposing Entities CMS/CANOPIUS NEW BUSINESS PROPOSAL FORM 2010 a) Please state below the name of your main practice. Please also enter below the full names of any other entities currently trading referring
More informationIMPORTANT NOTICE REGARDING COMPLETION OF THIS ACCOUNTANTS PROPOSAL FORM
IMPORTANT NOTICE REGARDING COMPLETION OF THIS ACCOUNTANTS PROPOSAL FORM 1. Disclosure - Any material fact must be disclosed to Insurers. - A material fact is any information which may alter the judgment
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR MANAGEMENT COMPANY
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR MANAGEMENT COMPANY Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block letters within the
More informationProfessional Indemnity Proposal Form Accountants
Professional Indemnity Proposal Form Accountants GUIDANCE NOTES Completing your proposal form Please complete all questions in full using the Additional Information section or separate sheets where necessary.
More informationSecurus Insurance Limited. Proposal Form. Miscellaneous Professional Indemnity
Securus Insurance Limited Proposal Form Miscellaneous Professional Indemnity Securus Insurance Limited Unit C2, Airside Enterprise Centre Swords Co Dublin Phone (01) 8074550 Fax (01) 8074553 Email info@securus.ie
More informationProfessional Indemnity Insurance Proposal Form for Accountants
QPI Professional Specialists in Protecting Professions Professional Indemnity Insurance Proposal Form for Accountants IMPORTANT INFORMATION Duty of Disclosure When completing any insurance proposal form
More informationMiscellaneous Professional Indemnity Insurance Proposal form
Miscellaneous Professional Indemnity Insurance Proposal form Instructions Please provide a full answer to every question. Please ensure that all answers are typewritten or printed in block letters with
More informationMISCELLANEOUS PROFESSIONAL INDEMNITY PROPOSAL FORM
MISCELLANEOUS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT NOTICE TO THE PROPOSER TO COMPLETION OF THIS PROPOSAL FORM 1) Disclosure - Any material fact must be disclosed to Insurers. - A material fact
More informationACCOUNTANTS PROFESSIONAL INDEMNITY PROPOSAL FORM
ACCOUNTANTS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT NOTICE TO THE PROPOSER TO COMPLETION OF THIS PROPOSAL FORM 1) Disclosure - Any material fact must be disclosed to Insurers. - A material fact
More informationIMPORTANT NOTICE REGARDING COMPLETION OF THIS MANAGEMENT CONSULTANTS PROPOSAL FORM
IMPORTANT NOTICE REGARDING COMPLETION OF THIS MANAGEMENT CONSULTANTS PROPOSAL FORM 1. Disclosure - Any material fact must be disclosed to Insurers. - A material fact is any information which may alter
More informationConstruction Professional Liability Insurance Proposal
AIG Europe Limited Proposer Details Name of Firm(s) Principal Address line one Principal Address line two City and postcode Telephone number Fax number Website address Is the Firm(s) a subsidiary of an
More information4. DETAILS OF THE PRINCIPAL(S) OF THE FIRM How Long Practicing as Partner/Director
SURA Professional Risks Level 13 / 141 Walker St North Sydney NSW 2060 P O BOX 1813 North Sydney NSW 2059 Telephone. 02 9930 9500 Facsimile. 02 9930 9501 sura.com.au ACCOUNTANTS PROFESSIONAL INDEMNITY
More informationSecurity Consultants. Professional Indemnity. Proposal Form
Thompson Heath & Bond Limited 107 Leadenhall Street London EC3A 4AF Tel: +44 (0) 20 7469 0100 Fax: +44 (0) 20 7621 0661 www.thbgroup.com Lloyd s Broker Security Consultants Professional Indemnity Proposal
More informationProfessional Indemnity Insurance Proposal Form for Accountants
QPI Professional Specialists in Protecting Professions Professional Indemnity Insurance Proposal Form for Accountants Short Proposal Form for 1-4 Partner Firms IMPORTANT INFORMATION Duty of Disclosure
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR PRIVATE MEDICAL INSURANCE BROKERS This proposal form must be completed in black ink by a Partner, Principal or Director of the Company. All questions
More informationProfessional Indemnity Insurance for Motor Traders Financial Product Sales. Proposal Form
Professional Indemnity Insurance for Motor Traders Financial Product Sales Proposal Form Professional Indemnity Insurance for Motor Traders Financial Product Sales Proposal Form Please read the following
More informationIMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM
Employment & Recruitment Agencies Professional Indemnity Insurance Proposal Form IMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM Method of Completion This proposal form may be completed in ink
More informationAPPLICATION FORM. Professional Indemnity Insurance
APPLICATION FORM Professional Indemnity Insurance Accountants/Auditors Instructions to the applicant. A. Please answer all questions. The information is required to make an underwriting and pricing evaluation.
More informationManagement Consultants. Professional Indemnity. Proposal Form
Thompson Heath & Bond Limited 107 Leadenhall Street London EC3A 4AF Tel: +44 (0) 20 7469 0100 Fax: +44 (0) 20 7621 0661 www.thbgroup.com Lloyd s Broker Management Consultants Professional Indemnity Proposal
More informationHow To Answer A Question From The Insurance Company
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR HEALTH & SAFETY CONSULTANTS This proposal form must be completed in black ink by a Partner, Principal or Director of the Company. All questions must be
More informationIMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM
Management Consultants Professional Indemnity Insurance Proposal Form IMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM Method of Completion This proposal form may be completed in ink or electronically
More informationAccountant Professional Liability Proposal Form
Notice: Statement pursuant to Section 25(5) of the Insurance Act (Cap 142) or any amendments thereof; You are to disclose in this application, fully and faithfully, all the facts which you know or ought
More informationBusiness Process Outsourcing/ Call Center Professional Liability Proposal Form
Business Process Outsourcing/ Call Center Professional Liability Proposal Form I. APPLICANT DETAILS Name of Insured: Address(es): Web Site Address: Establishment Date: II. BUSINESS ACTIVITIES 2. Please
More information100,000 250,000 500,000 1,000,000 2,000,000 Other Please Specify:
Intersure Insurance Brokers Limited Prospect House, 63 rth Street, Sudbury, Suffolk CO10 1RE Telephone: 01787 313133 Fax: 01787 313656 e-mail:enquiries@intersure.net www.intersureinsurance.com PROPOSAL
More informationPROPOSAL FORM FOR INTERNATIONAL INVESTMENT MANAGERS PROFESSIONAL INDEMNITY INSURANCE
PROPOSAL FORM FOR INTERNATIONAL INVESTMENT MANAGERS PROFESSIONAL INDEMNITY INSURANCE Prime International (a trading name of Miller Insurance Services LLP) 70 Mark Lane, London EC3R 7NQ Tel: +44 20 7488
More informationQuestionnaire & Application Pack. For. Business Consultants Professional Indemnity Insurance. This pack contains the following documents:-
Questionnaire & Application Pack For Business Consultants Professional Indemnity Insurance. This pack contains the following documents:- Our FSA Keyfacts document explaining who we are. Our FSA Demands
More informationManagement Consultants Professional Liability Proposal Form
Notice:Statement pursuant to Section 25(5) of the Insurance Act (Cap 142) or any amendments thereof; You are to disclose in this application, fully and faithfully, all the facts which you know or ought
More informationManagement Consultants Professional Liability Proposal Form
AIG Insurance Hong Kong Limited Management Consultants Professional Liability Proposal Form I. APPLICANT DETAILS Name of Insured: Address(es): Web Site Address: Establishment Date: II. BUSINESS ACTIVITIES
More informationProfessional Indemnity Insurance for Accountants Proposal Form
Professional Indemnity Insurance for Accountants Proposal Form Professional Indemnity Insurance for Accountants Proposal Form Please read the following carefully before completing this proposal form. To
More informationProfessional Indemnity Insurance for Archaeologists & Associated Professions
Professional Indemnity Insurance for Archaeologists & Associated Professions Proposal Form This Form applies to any individual or group or company undertaking archaeological projects, or providing archaeological
More informationAccountants Application Form
Accountants Application Form Application Form IMPORTANT: In this application: You / Your refers to all firms to be insured under this arrangement, including any predecessor or previous business for which
More informationBusiness Insurance Proposal
HOULDER INSURANCE SERVICES PROFESSIONAL INDEMNITY PROPOSAL FORM ACCOUNTANTS Michael's House 10-12 Alie Street, London E1 8DE Tel: 020 7980 3800 Fax: 020 980 3915 PLEASE READ THE FOLLOWING BEFORE COMPLETING
More informationMANAGEMENT CONSULTANTS PROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE
HCC International Walsingham House, 35 Seething Lane London EC3N 4AH, United Kingdom main +44 (0)20 7702 4700 facsimile +44 (0)20 7626 4820 MANAGEMENT CONSULTANTS PROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE
More informationPROFESSIONAL INDEMNITY PROPOSAL FORM
AAO Pana Insurance Brokers Sdn Bhd 29-1, Dataran Prima Business Centre, Jalan PJU 1/41, 47301 Petaling Jaya Tel : 03-7880 9277 Fax : 03-7880 8689 Web site : www.aaogroup.com PROFESSIONAL INDEMNITY PROPOSAL
More informationAccountants Professional Indemnity Insurance Proposal Form
Accountants Professional Indemnity Insurance Proposal Form Instructions This proposal form must be completed by a Principal, Director, Partner or Company Secretary of the Proposer. If there is insufficient
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ADVERTISING AGENTS PLEASE READ THIS GUIDANCE NOTE BEFORE COMPLETING THE PROPOSAL FORM To help us to provide you with our most competitive quotation, it
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ADVERTISING AGENTS
INTERSURE INSURANCE BROKERS LIMITED PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ADVERTISING AGENTS PLEASE READ THIS GUIDANCE NOTE BEFORE COMPLETING THE PROPOSAL FORM To help us to provide you with
More informationDICKSON MANCHESTER. Charity and Association Liability Proposal Form. Proposal form for Insurance effected through Dickson Manchester & Co Ltd
DICKSON MANCHESTER Charity and Association Liability Proposal Form Proposal form for Insurance effected through Dickson Manchester & Co Ltd A SUBSIDIARY OF HCC INSURANCE HOLDINGS, INC. Member of the General
More informationIT PROFESSIONALS PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM
IT Professionals Professional Indemnity Insurance Proposal Form IMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM Method of Completion This proposal form may be completed in ink or electronically
More informationSurveyors & Real Estate Professional Liability Proposal Form
AIG Insurance Hong Kong Limited Surveyors & Real Estate Professional Liability Proposal Form I. Applicant Details Name of Insured: Address(es): Web Site Address: Establishment Date: II. Business Activities
More informationProfessional Indemnity Select
Allianz Insurance plc Professional Indemnity Select Insurance Brokers Proposal Form Insurance Professional Brokers Indemnity Professional Policy Overview Indemnity Select Insurance Brokers Professional
More informationMultimedia Professional Indemnity Insurance Proposal
SIGNING THIS PROPOSAL DOES NOT BIND THE PROPOSER TO COMPLETE THIS INSURANCE Multimedia Professional Indemnity Insurance Proposal 1. (a) Name of Firm(s) (b) Company registration number: (c) Address(es)
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM - ACCOUNTANTS
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM - ACCOUNTANTS IMPORTANT Answer all questions. Blanks, dashes, answers known to underwriters or brokers or N/A are not acceptable and will delay consideration
More informationE nvironm ental Consultants
Professional Indemnity Insurance Proposal for E nvironm ental Consultants PROFESSIONAL RISKS 2nd Floor John Stow House 18 Bevis Marks London EC3A 7JB Tel 020 7623 4957 Fax 020 7623 4958-1- PROFESSIONAL
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ARCHITECTS
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ARCHITECTS This proposal form must be completed in black ink by a Partner, Principal or Director of the Company. All questions must be answered to enable
More informationBusiness Process Outsourcing / Call Center Professional Liability Proposal Form
AIG Insurance Hong Kong Limited Business Process Outsourcing / Call Center Professional Liability Proposal Form I. APPLICANT DETAILS Name of Insured: Address(es): Web Site Address: Establishment Date:
More informationProfessional Indemnity Proposal Form Project Management
Professional Indemnity Proposal Form Project Management GUIDANCE NOTES Completing your proposal form Please complete all questions in full using the Additional Information section or separate sheets where
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM FOR ARCHITECTS PLEASE READ THIS GUIDANCE NOTE BEFORE COMPLETING THE PROPOSAL FORM To help us to provide you with our most competitive quotation, it is important
More informationFinancial Advisers Professional Indemnity Insurance Proposal Form
Financial Advisers Professional Indemnity Insurance Proposal Form IMPORTANT Disclosure of material facts or information It is essential that every Proposer or Insured when seeking a quotation, taking out
More informationHow To Write A Professional Indemnity Proposal Form For Management Consultants
Professional Indemnity Insurance Management Consultants Proposal Form Towergate Lifestyle Suite 4b, 1 Portland Street, Manchester, M1 3BE Tel: 0844 892 1789 Fax: 0844 892 1796 Email: lifestyle@towergate.co.uk
More informationMISCELLANEOUS PROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE
HCC International Walsingham House, 35 Seething Lane London EC3N 4AH, United Kingdom main +44 (0)20 7702 4700 facsimile +44 (0)20 7626 4820 MISCELLANEOUS PROPOSAL FORM PROFESSIONAL INDEMNITY INSURANCE
More informationIndustry Insurance Proposal
Media Professionals Professional Indemnity Insurance Proposal Form IMPORTANT INFORMATION REGARDING COMPLETION OF THIS FORM Method of Completion This proposal form may be completed in ink or electronically
More information1. NAME OF FIRM TO BE INSURED 2. ADDRESS OF FIRM 3. THE FIRM. (please include full names of all entities to be insured) Phone ( ) Email
SURA Professional Risks Level 13 / 141 Walker St North Sydney NSW 2060 P O BOX 1813 North Sydney NSW 2059 Telephone. 02 9930 9500 Facsimile. 02 9930 9501 sura.com.au MISCELLANEOUS PROFESSIONAL INDEMNITY
More informationPROFESSIONAL INDEMNITY INSURANCE
PROFESSIONAL INDEMNITY INSURANCE Accountants Proposal Form A FULL POLICY WORDING IS AVAILABLE ON REQUEST Please ask your broker, usual RSA contact or see our website, www.rsabroker.com Please complete
More informationPROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM
PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM For Surveyors (excluding Marine and Engineering), Quantity Surveyors, Auctioneers, Valuers and Estate Agents Please ensure that all relevant sections of the
More informationIMPORTANT NOTES ABOUT PROFESSIONAL INDEMNITY INSURANCE
Page 1 of 6 IMPORTANT NOTES ABOUT PROFESSIONAL INDEMNITY INSURANCE Professional Indemnity insurance is different from most other types of insurance. The policy is issued on a "claims made" basis and a
More informationProfessional Indemnity Insurance for Specialist Consultants/Firms Proposal Form
Professional Indemnity Insurance for Specialist Consultants/Firms Proposal Form Professional Indemnity Insurance for Specialist Consultants/Firms Proposal Form Please read the following carefully before
More informationProfessional Indemnity Proposal Form Surveyors
Professional Indemnity Proposal Form Surveyors GUIDANCE NOTES Completing your proposal form Please complete all questions in full using the Additional Information section or separate sheets where necessary.
More informationProfessional Indemnity Insurance. Proposal for PROFESSIONAL RISKS. 2nd Floor John Stow House 18 Bevis Marks London EC3A 7JB
Professional Indemnity Insurance Proposal for IT Consultants PROFESSIONAL RISKS 2nd Floor John Stow House 18 Bevis Marks London EC3A 7JB Tel 020 7623 4957 Fax 020 7623 4958 PROFESSIONAL RISKS Kerry London
More informationProposal Form for Professional Indemnity Insurance INVESTMENT MANAGERS AND OTHERS
Proposal Form for Professional Indemnity Insurance INVESTMENT MANAGERS AND OTHERS THIS APPLICATION IS FOR A CLAIMS MADE INSURANCE POLICY GENERAL INFORMATION 1. Please state the name and address of all
More informationAccountants Professional Indemnity Insurance
Accountants Professional Indemnity Insurance Instructions Please provide a full answer to every question. A Partner/Director/Principal must sign and date this form and any separate sheets on behalf of
More informationProfessions TechGuard Proposal Form
Proposer Details Name of Firm(s) Principal Address of Company line one Principal Address of Company line two City and postcode Telephone number Fax number Website Date Firm(s) was Established If less than
More informationProfessional Indemnity Select
Allianz Insurance plc Professional Indemnity Select Accountants Proposal Form Contents Accountants Professional Indemnity Insurance 1 General Information 2 Thank you for choosing Allianz Insurance plc.
More informationArchitects Professional Liability Insurance Proposal
AIG Europe Limited Proposer Details Name of Firm(s) Principal Address line one Principal Address line two City and postcode Telephone number Fax number Website address Is the Firm(s) a subsidiary of an
More informationArchitects. Professional Indemnity. Proposal Form
Thompson Heath & Bond Limited 107 Leadenhall Street London EC3A 4AF Tel: +44 (0) 20 7469 0100 Fax: +44 (0) 20 7621 0661 www.thbgroup.com Lloyd s Broker Architects Professional Indemnity Proposal Form THB
More informationInformation Technology Consultants Proposal Form
Proposal Form This Proposal form must be completed in ink, signed and dated by a Principal, Partner or Director of the Proposer. All questions must be answered and where appropriate not applicable or n/a
More information