Category with enquiry forms

1Profession

2Risk Details

3Business Conduct

4Financial Position

5Claims History

6Insurance Cover

Profession or Project Type
Please Choose One*
- Solicitors & Lawyers
- Real Estate Agents & Valuers
- Financial Advisors
- Construction Consultants
- Accountants
- Single Project

Claims History
1) Has any partner, principal, director or staff member ever been subject to disciplinary proceedings for professional misconduct?
- Yes
- No
If “Yes”, please supply details.
2) Have any claims for negligence or breach of professional duty been made in the last ten (10) years against your practice or any of its predecessors in business or any prior practice of any of your practice’s present or former partners, principals or directors, or have circumstances been notified to insurers that might give rise to a claim?
- Yes
- No
If “Yes”, please provide the following details in respect of each matter on your company’s letterhead and attach:
• Date of Claim made
• Name of Insurer (if any)
• Name of Claimant or Potential Claimant
• Brief description of matter and latest update • Amounts (If any) of claim paid and estimated outstanding amounts
• Is matter finalised or outstanding and when was the last update?
• What actions have been undertaken to prevent a recurrence of the situation which gave rise to each claim?
Accepted file types: jpg, jpeg, pdf, png, doc, docx, Max. file size: 10 MB.
If "Yes", please supply details
3. Are there any circumstances not already notified to Insurers which may give rise to a claim against you?
- Yes
- No
If “Yes”, please provide the following details in respect of each matter on your company’s letterhead and attach
• Name of Claimant or Potential Claimant
• Brief Description of Matter
• Estimate of Potential Liability
Accepted file types: jpg, jpeg, pdf, png, doc, docx, Max. file size: 10 MB.
3) Are any of the partners, principals or directors, AFTER ENQUIRY, aware of any claim or circumstances that might give rise to a claim against your practice or any prior practice or any of their present or former partners, principals or directors which matter is not referred to in question F.2 above?
- Yes
- No
If "Yes", please provide the following details in respect to each matter.

Insurance Cover
1. Limit of indemnity required:
2. Deductible/Excess requested (Each and every Claim):
Period of Insurance (From)
MM slash DD slash YYYY
Period of Insurance (To)
MM slash DD slash YYYY
1. Does your practice presently carry, or has your practice ever carried, professional indemnity insurance?
- Yes
- No
If “Yes”, please supply details:
Insurer
Expiry Date
MM slash DD slash YYYY
Limit of Indemnity
Deductible
Hidden
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2. Has your practice or any partner, principal or director ever been refused this type of insurance, or had similar insurance cancelled, or had an application of renewal declined, or had special terms imposed?
- Yes
- No
If “Yes”, please supply details.
Application For Cover
1. Limit of indemnity required:
2. Deductible/Excess requested (Each and every Claim):
3) Extensions
i) Automatic Extensions
• Libel and slander Automatically Included
• Loss of documents Automatically Included
• Consultants, subcontractors and agents Automatically Included
• Intellectual property Automatically Included
• Joint venture liability Automatically Included
• Newly created or acquired entity or subsidiary Automatically Included
• Run-off cover insured entity or subsidiary Automatically Included
• Estates and legal representatives Automatically Included
• Outgoing principals Automatically Included
ii) Please indicate if you seek cover for the following optional extension.

Category with enquiry forms

Profession or Project Type

Risk Details

1. Please provide the following details

2. Please summarise the expected time schedule for the project

4. Which of the following professional duties are required to be performed by or on behalf of you within the provisions of the contract?

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2) Please supply total numbers of

Business Conduct

1. Are there any aspects of the project (or part of the project) which:

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Details of Activities

Life Insurance Sales

General Insurance

Financial Planning

2) In respect of Investment Advice: Do you promote or sell strategies that encompass:

Risk management

6) Please detail the approximate percentage of your fees or other consulting income derived from the following fields of work:

6) Please detail the approximate percentage of your fees or other consulting income derived from the following fields of work:

6. Please categorise your activities or business conducted and indicate the approximate percentage of your fee income derived from each activity.

6. Please categorise your activities or business conducted and indicate the approximate percentage of your fee income derived from each activity.

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7) Please detail the approximate percentage of your total work in the following areas:

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8.1) Please detail the approximate percentage of your fee income FOR VALUATION WORK derived from the following areas:

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Financial Position of the Corporation

2. Please provide the amount of gross income/fees for the following

4. Please provide the approximate percentage of your activities (based on fee income) applicable to each country/region from which you derive a portion of your income.

Claims History

Insurance Cover

If “Yes”, please supply details:

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Application For Cover