Professional Liability Insurance Quote

General Information

Title

First name

Surname

Company name/Legal title

Company status

Address (first line)

Postcode

Daytime phone number (including STD code)

Evening phone number (including STD code)

Email address

Occupation/Profession

Additional occupation/profession

Business activities

Gross income/fees for last financial year or projected for this year

Is 100% of your fees derived from UK territory?YesNo

How many years has the business been trading?

How many years experience do you have this in trade?

What level of indemnity is required?

What is your target premium?

What date do you require cover from?

Proposer's Experience

Can you confirm that

at least 50% of all directors, partners, principals and consultants are suitably qualified or have at least 3 years relevant experience? YesNo

there have been no significant fluctuations in the Proposer's income or change in activities over the last 3 financial years and none are anticipated in the forthcoming year? (not applicable where the Proposer has been established for less than 3 years)YesNo

the Proposer does not act as a self employed contractor for one employer?YesNo

Claims

Have you any Professional Indemnity claims within the past 5 years?YesNo

Proposer's Security

Can you confirm that

all cheques drawn for more than £25,000 require two signatories (including at least one partner)? (Not applicable where you are a sole trader)YesNo

satisfactory written references are always obtained from former employers for the 3 years immediately preceding the engagement of any employee responsible for money, accounts or goods?YesNo

Declaration

Have you or any director, manager, partner or trustee of the Proposer or any person insured or proposing for insurance:

been convicted, or charged but not yet tried, of any criminal offence other than a motoring offence?YesNo

been declared bankrupt, gone into insolvent liquidation, or been the subject of receivership or an administration order?YesNo

ever had an application for this type of insurance declined by an insurer, had a renewal of such insurance declined, or had similar insurance cancelled or made subject to special conditions?YesNo

Is anyone proposing for insurance aware, after enquiry, of any circumstance or incident which they have reason to suppose might afford grounds for any future claim such as would fall within the scope of the proposed insurance which has not already been advised to us?YesNo

Enter the code you see below:

Professional Indemnity

General Information

Proposer's Experience

Claims

Proposer's Security

Declaration

Insurance

Policy Type

Shop / Savings