Your Professional Indemnity Solution.

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1 Pinsure Your Professional Indemnity Solution. 18 Henfield Business Park, Shoreham Road, Henfield, West Sussex, BN5 9SL Tel ~ Fax Web: DAS Legal Expenses Form The cover comprises: Employment Disputes and Awards Legal Defence Statutory Licence Protection Property Protection Bodily Injury Tax Protection Eurolaw Commercial Legal Advice Tax Advice Business Assistance Counselling DASbusinesslaw Please complete this form in BLOCK CAPITALS IMPORTANT INFORMATION This proposal form must be completed and signed by a Principal, Partner or Director of the Proposer. The person completing and signing the form should be authorised by the Proposer to do so and should make all necessary enquiries of his fellow Partners, Directors and Employees to enable all the questions to be answered.

2 You MUST complete all sections of this Proposal Form. DAS Legal Expenses Acceptance Form If you wish to proceed with DAS Legal Expenses Insurance please complete and return this page. Trading Name: Address: Postcode: Occupation: Band Turnover Premium inclusive of Insurance Premium Tax A Turnover up to 500, Please Tick B Turnover from 500,001 to 1,000, C Turnover from 1,000,001 to 2,500, D Turnover from 2,500,001 to 5,000, E Turnover over 5,000,000 To be referred to Insurers Please see attached the Outline of Cover Limit of Indemnity Basis: Wording: Security: Conditions / Extensions Applicable: 100,000 per insured incident DAS Club Commercial Legal Protection (copy available on request) 100% DAS Legal Expenses Insurance Company Ltd All as per the policy wording Inception Date of cover: Day Month Year I wish to pay by: BACS Payment Cheque Debit Card Credit Card (4.0% Charge) Payment by card - Once you receive your Debit Note please contact us with your card details which must also include your 3 digit security code. Payment will be taken immediately and your details securely destroyed. Signature of Principal / Director / Partner: Date: Page 1 e: t: f: DAS

3 Pinsure Limited Terms of Business If you do not understand any of the terms or conditions please contact us. Also if you require any additional covers not shown, or if you feel that the sum insured does not accurately reflect your circumstances. As required by the FSA, we must advise that it is possible that the policy may become subject to additional taxes which are payable by the insured. IMPORTANT:- Please read this statement carefully in conjunction with the above quotation and contact our office if you have any queries or concerns on this subject. We recommend these terms to you: they have been offered on a policy wording and at terms & conditions that are suitable to your insurance requirements as specified in the information and instructions you have provided to us. We would remind you of your duty of disclosure; to disclose, clearly and accurately, all material facts relating to the proposed insurance before the contract is finalised. If you have any doubt as to what constitutes a material fact or circumstance please do not hesitate to ask us for clarification. Any breach of this duty by the proposer may entitle the insurer to repudiate liability. Pinsure hereby responds to your request for quotations for professional liability insurance suitable to your business needs and requirements as detailed within your proposal form. Please be aware that you may also require other forms of insurance cover for which Pinsure Limited is unable to advise. The Financial Services Authority (FSA) is the independent watchdog that regulates financial services. It requires us to provide you with the following information, use it to decide if the services are appropriate for you. Permitted to arrange general insurance contracts Pinsure Limited is an FSA regulated firm trading in compliance with FSA regulations. Our FSA firm registration number is details of which may be checked on the FSA s register by visiting their website or by contacting the FSA on Pinsure offer a quotation from a single insurer chosen by Pinsure on your behalf for their potential suitability to provide you with a product that meets your requirements. We will advise and make a recommendation for you after we have assessed your needs. Pinsure normally receives a commission from the insurer with whom we place your business, details are available. Pinsure Limited makes a charge to cover the administration of your insurance: details of your fee will be found on your quotation. Please be advised that in the majority of cases professional liability insurances cannot be cancelled by the policy holder. Refer to your specific policy wording for the insurer s procedure. Pinsure Limited will charge a cancellation fee of 100 to cover administration should cancellation be granted. All client monies received by Pinsure Limited are protected in Statutory Trust Client Bank Accounts pending settlement to insurers. Please be aware that Pinsure may transfer funds to other FSA authorised underwriters for them to make settlement to insurers. We do not pay any interest on premiums held by us in the course of arranging and administering your insurance. We will treat all your personal information as private and confidential to us and anyone else involved in the normal course of arranging and administering your insurance, even when you are no longer a customer. We will not give anyone else any personal information except on your instructions or authority, or where we are required to do so by law, or by virtue of our regulatory requirements. We may use information we hold about you to provide information to you about other products and services, which we feel may be appropriate to you. Under the Data Protection Act 1998 you have the right to see any personal information about yourself, which we hold in our records. If you have any queries please write to us at our usual office address. Our aim is to provide a first class service, however, if you wish to register a complaint, please contact us by writing to Kevin Locke, Pinsure Limited, 58 High Street, Steyning, West Sussex, BN44 3RD or, by phone Telephone , by fax We will provide you with a copy of our full complaints procedure and respond to you as a matter of urgency, and always within 5 working days. We will aim to make a final response to you within eight weeks, or keep you informed as to why this is not possible. In the event that your complaint relates to activities or services provided by another party, we will ensure that your complaint is appropriately forwarded, and will track the progress of the complaint and responses of that party. After our final response has been issued, if you still cannot settle your complaint with us, you may be entitled to refer it to the Financial Ombudsman Service, for an independent assessment and opinion. The FOS Consumer Helpline is on and their address is: Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, London E14 9SR We are covered by the Financial Services Compensation Scheme (FSCS). You may be entitled to compensation from the scheme if we cannot meet our obligations. This depends on the type of business and the circumstances of the claim. Insurance advising and arranging is covered for 100% of the first and 90% of the remainder of the claim, without any upper limit. For compulsory insurances e.g. employer s liability, insurance advising and arranging is covered for 100% of the claim, without any upper limit. Further information about compensation scheme arrangements is available from the FSCS. Page 2 e: t: f: DAS

4 COMMERCIAL LEGAL PROTECTION CLUB OUTLINE OF COVER Please note that this document provides an outline of the cover but does not contain details of waiting periods, conditions or exclusions. For full policy terms and conditions please contact your insurance adviser and ask for a specimen policy. The policy will pay legal costs up to 100,000 including solicitors and barristers fees, court costs, expenses for expert witnesses, attendance expenses, accountants fees and employment compensation awards. It will also pay the costs of appealing or defending an appeal. EMPLOYMENT DISPUTES AND COMPENSATION AWARDS (a) Employment Disputes Defending your legal rights prior to the issue of proceedings in a court or tribunal following dismissal of an employee. Defending your legal rights in respect of any dispute with an employee or ex-employee or a trade union acting on their behalf relating to their contract of employment. Defending your legal rights in respect of any dispute with an employee, prospective employee or ex-employee arising from an alleged breach of their statutory rights under employment legislation. Please note that waiting periods may apply to claims that arise from employment disputes. (b) Compensation Awards In respect of a claim we have accepted under Employment Disputes cover, we will pay any basic and compensatory award and/or compensation awards arising from an alleged breach of an employee, prospective employee or ex-employee s statutory rights under employment legislation; provided that throughout the employment dispute, you have either followed the ACAS Code of Disciplinary and Grievance Procedures in Employment, the equivalent codes of practice issued by the Labour Relations Agency in Northern Ireland, or sought and followed advice from the DAS legal advice service. (c) Service Occupancy Negotiating for your legal rights against an employee or ex-employee to recover possession of premises which are owned by you or for which you are responsible. LEGAL DEFENCE Defending your legal rights or your employees legal rights prior to legal proceedings when dealing with the police or the relevant Health and Safety authority where it is alleged that you or your employees have or may have committed a criminal offence in connection with your business activities. Defending non-motor criminal prosecutions arising from your business activities. Defending civil actions taken against you or your employees for compensation under section 13 of the Data Protection Act 1998, including the payment of any compensation award made against you or your employees. Appealing against the refusal of the Information Commissioner to register your application for registration. Defending your employees legal rights if civil action is taken against them under legislation for unlawful discrimination. Defending your employees legal rights if civil action is taken against them as a trustee of a pension fund set up for the benefit of your employees. Appealing against the imposition or terms of any Statutory Notice issued under UK legislation affecting your business. Defending a civil action taken against you for wrongful arrest in respect of an accusation of theft. The attendance expenses of your employees for jury service. PROPERTY PROTECTION AND BODILY INJURY (a) Property Protection Pursuing your legal rights in a civil action following an event causing physical damage to material property which you own or are responsible for, or any nuisance or trespass. Page 3 e: t: f: DAS

5 (b) Bodily Injury At your request, pursuing your employees and their family members legal rights following an event causing the death of or bodily injury to them in a non-motor accident. Page 4 e: t: f: DAS

6 STATUTORY LICENCE PROTECTION Appealing to the relevant statutory or regulatory authority, court or tribunal, following a decision by a licensing or regulatory authority to suspend, alter, refuse to renew or cancel your licence, mandatory registration or British Standard Certificate of Registration. CONTRACT DISPUTES COVER Negotiating for your legal rights in a contractual dispute arising from an agreement or alleged agreement entered into by you or on your behalf, for the purchase or hire or sale or provision of goods or services, providing the amount in dispute exceeds 250 and does not exceed 5,000. TAX PROTECTION (a) Full Enquiries or Aspect Enquiries Negotiating on your behalf and representing you in any appeal proceedings in respect of a full or aspect enquiry carried out by HM Revenue & Customs. (b) Tax Intervention Enquiries Negotiating on your behalf and representing you in any dealings with HM Revenue & Customs in respect of a tax intervention enquiry. A 200 excess applies for aspect enquiries and tax intervention enquiries and there is an inner limit of indemnity of 2,000. (c) Employer s Compliance Negotiating on your behalf and representing you in any appeal proceedings in respect of a dispute concerning your compliance with Pay As You Earn or Social Security Regulations following a review by HM Revenue & Customs. (d) VAT Disputes Negotiating on your behalf and representing you in any appeal proceedings following an assessment issued by HM Revenue & Customs in respect of Value Added Tax due. Helpline Services The following helpline services are available 24 hours a day, 365 days a year during the period of insurance. EuroLaw Commercial Legal Advice We will provide you with a confidential legal advice service over the phone on any commercial legal problem affecting your business subject to the laws of the member countries of the European Union, the Isle of Man, the Channel Islands, Switzerland and Norway. Tax Advice We will provide you with confidential advice over the phone on any tax matters affecting your business under the laws of the United Kingdom. Business Assistance In the event of any unexpected emergency affecting your business premises which causes damage or potential danger, we will contact a suitable repairer or contractor and arrange assistance on your behalf. All costs of assistance provided will be your responsibility. Counselling Helpline We will provide all employees (and members of their immediate family who always live with them) with a confidential counselling service over the phone including, where appropriate, onward transmission to relevant voluntary and/or professional services. Employment Manual The DAS Employment Manual offers comprehensive, up to date guidance on rapidly changing employment law. To view it, please visit our website at DASbusinesslaw DASbusinesslaw provides an on-line business support system which allows free access to over 600 model business documents, specimen letters and business guides on a wide range of subjects from employing someone to writing a marketing plan. Regular information bulletins and daily business news is also available from the site. Page 5 e: t: f: DAS

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