Chartered Tax Institute f Malaysia Prfessinal Indemnity Insurance Prgramme Managed By: Marsh Insurance Brkers (Malaysia) Sdn Bhd Cmpany N: 88363-U Unit B-9-1, Level 9 Twer B, Menara UOA Bangsar N. 5, Jalan Bangsar Utama 1 59000 Kuala Lumpur Tel: +603 2302 8488, Fax +603 2301 0913 / 0923 Underwritten By: QBE Insurance (Malaysia) Berhad (161086-D) N. 638 Level 6, Blck B1 Pusat Dagang Setia Jaya (Leisure Cmmerce Square) N. 9 Jalan PJS 8/9 46150 Petaling Jaya Tel: +603 7861 8400, Fax:+603 7873 7430
Chartered Tax Institute f Malaysia Prfessinal Indemnity Insurance Prgramme Intrductin Abut Marsh Insurance Brkers (M) Sdn Bhd As the leading glbal insurance brking and risk advisry firm, Marsh, a jint venture between Marsh Inc. and Zulayang Sdn Bhd, has been servicing clients in Malaysia since 1982. Marsh wrks with many successful multinatinal crpratins, lcal Malaysian cmpanies as well as Malaysian glbal ventures. We prvide clients and partners a cmprehensive range f insurance and risk management services fr virtually every type f industry and prfessin. Our 100 prfessinals, based in Kuala Lumpur and Penang, are dedicated t creating and implementing innvative risk management and insurance slutins t help clients succeed. Marsh has unparalleled experience in servicing a wide variety f prfessins in Asia. It s Financial and Prfessinal Practice (FINPRO) has a much-envied track recrd fr finding innvative and cst-effective slutins t the risks financial institutins and prfessinals face. In additin t prgram design and placement, we prvide advisry services such as claims advcacy, benchmarking, and industry trend analysis. Marsh prvides supprt thrughut the lifecycle, frm understanding risk, prgram design, nging supprt, claims advcacy and renewal. Marsh understands that arranging insurance is nly part f the picture. We als prvide a high level risk prfile assessment and gap analysis fr management t make infrmed decisins. Abut QBE Malaysia QBE Malaysia was established in 1987 and is a 100% wned subsidiary f the QBE Insurance Internatinal Grup f Australia. QBE was first represented in Malaysia in 1905 thrugh the appintment f an Underwriting Agency and have since develped a strng presence and slid reputatin f prviding innvative and prgressive slutins t ur vast range f clients in the Malaysian market. We currently perate frm ur Central Office in Petaling Jaya and have 8 Business Units at majr business centres thrughut bth Peninsula and East Malaysia. QBE Malaysia, thrugh its netwrk f ffices, ffers a cmprehensive range f quality prducts t meet the varied insurance needs f crprate, prfessinal and individual clients. We have ver the years, earned a reputatin f being ne f the leaders bth in Malaysia and in the Regin, in insuring risks expsures faced by prfessinals thrugh ur wide range f Prfessinal Indemnity Insurance fferings. Fr mre details n ur prducts and services, please apprach yur servicing insurance brker r an authrised QBE representative. Yu may als yu cntact any f ur branch ffices. Please visit ur website www.qbe.cm.my r email us at inf.mal@qbe.cm, if yu shuld require immediate infrmatin. We lk frward t being able t meet yur needs and becme yur 'first chice' fr insurance.
Chartered Tax Institute f Malaysia Prfessinal Indemnity Insurance Prgramme The Cverage f the Prfessinal Indemnity Insurance The QBE Plicy ffers a bradfrm insuring clause in which QBE shall pay n behalf f the Insured firm any lss frm a claim fr civil liability arising frm the cnduct f prfessinal services r advice. The cverage is ffered t a Tax Practitiner registered under Sec.153 f Incme Tax Act 1967 (Act 53) and wh hlds a valid practising certificate issued by the Chartered Tax Institute f Malaysia. Plicy Features Scpe f Cver Breach f Cnfidentiality Cntractual Liability arising frm the Insured s duty f care t prvide prfessinal services (ther than liabilities attaching by way f warranties, guarantees r hld harmless agreements) Defamatin Unintentinal Infringement f Intellectual Prperty Rights (including patents) Jint Venture Liability fr the Insured s prprtin f their liability Legal Liability frm the lss f dcuments Trade Practice claims Vicarius Liability f yur Insured fr wrk dne by a third party Autmatic Extensins Cmpensatin fr Curt Attendances Cntractrs and Cnsultants (cverage fr direct legal liability f yur cntractrs r cnsultants prvided that 90% f their incme is derived frm the Insured and that they are under the Insured s direct cntrl r supervisin) 90 day extended reprting perid granted withut additinal premium charged, if the plicy is nt renewed r cancelled withut replacement cver Autmatic cver fr newly created r acquired subsidiaries at n additinal premium (subject t cnditins within plicy) Csts f fficial investigatins and enquiries nt tied t a Claim Public Relatins Expenses Csts f replacing dcuments
Chartered Tax Institute f Malaysia Prfessinal Indemnity Insurance Prgramme Special Features Nn-cancellable This Plicy is nn-cancellable by QBE unless premium is nt paid. Severability and Nn-Imputatin The rights f any inncent insured will nt be prejudiced by the failure t disclse, r nn-cmpliance with the terms f the plicy, r any misrepresentatin, by any ther insured. Waiver f Subrgatin The Plicy incrprates a waiver f rights f subrgatin against any principal, partner, directr, r past r present emplyee f the Insured unless the act cmmitted is fraudulent, dishnest r criminal, r a wilful breach f any statute, regulatin, cntract r duty. Acts cmmitted in reckless disregard This Plicy des nt exclude fraudulent r dishnest acts referenced t acts cmmitted in reckless disregard. Nn-mnetary Civil Relief The definitin f Cmpensatin under this Plicy is expanded t include the csts f legally cmplying with a nn-mnetary civil relief. Imprtant Nte: The abve highlights are merely descriptive. Please refer t the plicy wrdings fr the cmplete details f cverage, terms and cnditins. Fr enquiries please cntact r email: Marsh Insurance Brkers (Malaysia) Sdn Bhd Cmpany N: 88363-U Unit B-9-1, Level 9 Twer B, Menara UOA Bangsar N. 5, Jalan Bangsar Utama 1 59000 Kuala Lumpur Tel: +603 2302 8488 Fax: +603 2301 0913 / 0923 Email: ctimpii@marsh.cm
QBE Prfessinal Indemnity Insurance Prpsal Frm _ Specially designed fr CTIM members Yur Duty f Disclsure: Befre yu enter int a cntract f general insurance with an insurer, yu have a duty t disclse t the insurer every matter which yu knw, r culd reasnably be expected t knw, is relevant t the insurer's decisin whether t accept the risk f the insurance and, if s, n what terms. Yu have the same duty t disclse thse matters t us befre yu renew, extend, vary r reinstate a cntract f insurance. Insurance Act 1996: Yu are t disclse in this prpsal frm, fully and faithfully all the facts which yu knw r ught t knw, therwise the plicy issued hereunder may be vid. Please cmplete infrmatin in full and check bxes where apprpriate. A. Prpser s Infrmatin Tax Agent Name Tax Agent Firm CTIM N. NRIC/Passprt N. Pstal Address Tax Agent License N. Telephne N. e-mail address B. Insurance Cverage Details Annual Grss Incme Fees Limit f Indemnity Excess Ttal Premium Nt mre than RM500,000 RM 150,000 any ne claim and in the aggregate RM1,000 each and every claim RM 307.40 inclusive f 6% Service Tax If yur Annual Grss Incme Fees exceed RM 500,000 and/r if yu require a higher Limit f Indemnity, kindly cntact: Marsh Insurance Brkers (M) Sdn Bhd at +603-2302 8488 r email t ctimpii@marsh.cm C. Insurance Histry If the answer t any f the fllwing questins is YES, please prvide details ver a perid f three (3) years, in a separate sheet:- a) Have yu ever been subject t a reprimand? Yes N b) c) Have any claims been made against yu r negligence alleged against yu t date? Are yu aware f any circumstance which may result in a claim being made against yu? Yes Yes N N
D. Payment Optins Amunt Payable (RM) Cash Cheque Fr cheque payment, cheque shuld be crssed and made payable t "QBE Insurance (Malaysia) Berhad" Cheque details Bank Cheque N. Please charge the ttal premium t my credit card (check where applicable) Name f Cardhlder Visa MasterCard Card N. - - - Card Expiry: / Cardhlder s Signature: / / Date (dd/mm/yy) E. Declaratin by Insured I/We d hereby declare that: 1. I am/we are authrised t make this prpsal. 2. The answers stated in this prpsal are true and cmplete and I have nt withheld any infrmatin which may influence the acceptance f this applicatin. 3. This applicatin and declaratin hereby given shall be the basis f the cntract with the Cmpany and I/we will accept the terms, exclusins and cnditins which will be set ut in the plicy t be issued. 4. The liability f the Cmpany des nt cmmence until the applicatin has been accepted. Signature Date / /