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Graybrook
01245 321185
Home
Meet the Team
Links
Testimonials
News
Contact Us
Terms of Business
Terms of Business Consumer
Terms of Business Commercial
Privacy Notice
Covid-19 Information
Covid-19 and Insurance
Pandemic Planning
Rapid Implementation
Protecting Unoccupied Premises
Related Home Working Guidance
Frequently Asked Questions
Hospitality Industry - Planning to Reopen Guidance
Hospitality Industry - Planning to Reopen Checklist
Staying Covid-19 Secure
Business Insurance
Business Insurance
Management Liability
Equipment Insurance
Professional Bodies
Professional Bodies, Charities,
Trade Unions & Associations
Education
Prospect Members
NAHT & NAHT Edge Members
Educational Consultants
Paramedics
College of Paramedics
HPA Members
Paramedic Insurance
Orthoptics
BIOS Members
Equipment Insurance
Physiotherapy
Practice Insurance
Business Liability Insurance
Equipment Insurance
CSP Members
Physio First Members
AACP Members
ACPAT Members
MACP Members
CSP Sports Massage
Top-Up
Locum Cover
Massage & Fitness
Sports Massage
CSP Sports Massage
BASRaT Members Insurance Benefits
BASRaT Top Up
BASRaT Student Sports Massage
UKSCA Members
Intrinsic Biomechanics Association
Move It or Lose It Trainers
Equipment Insurance
Other Therapies
Manual Handling
NBE Members
Complementary Therapy
Equipment Insurance
Criminal Prosecution
Criminal Defence Costs
Equipment Insurance Application Form (including summary of cover)
Date: 25/02/2021
Step 1
Step 2
APPLICATION FORM
SUMMARY OF COVER
PROPERTY INSURED: Healthcare Equipment
INSURER: Aviva
COVER: Business All Risks Maximum Sum Insured: £5,000
GEOGRAPHICAL LIMITS: Anywhere in the World up to a maximum of 90 days in any 12 month period
PREMIUM: £150.00 (inclusive of Insurance Premium Tax & Policy Fees)
SPECIAL CONDITIONS:
(a) The first £100 of any claim is excluded.
(b) In respect of theft from unattended vehicles no cover applies:
(i) unless the vehicle is securely locked (or otherwise kept in a securely locked building)
(ii) between midnight and 0600hrs unless the vehicle is both locked and kept in a securely locked building.
(c) When transported by sea or air, the equipment must be carried as hand luggage and accompany the policyholder.
(d) Cover excludes mechanical and electrical breakdown, failure of parts, mobile telephones or other unrelated equipment
(e) Policyholders have a duty at all times to take reasonable precautions to safeguard the property insured and to disclose facts which may materially affect acceptance of the cover
(f) The Date Recognition General Exception
(g) No cover applies where the policyholder lends or hires out to others the equipment insured
(h) When not in use the equipment must be kept in a securely locked fast building
This summary is not intended to be exhaustive and does not in any way alter the terms of the policy.
A full copy of the policy wording, terms and conditions are available online from our website www.graybrook.co.uk/equipment. Applicants who do not have internet access may apply for a copy to be sent by post prior to purchase.
Title
Mr
Mrs
Miss
Ms
Dr
Name of Proposer
Business Description:
Address:
Postcode
Telephone No:
Email Adress:
Date Cover To Commence:
As detailed above the annual premium is £150, and please confirm how you would like to pay
Bank Transfer
By Card (please call me)
Cheque
Disclosure of Material Facts Declaration
To the best of your knowledge have there been any claims made against you in respect of any of the covers now proposed?
Yes
No
Are you aware of any existing circumstances which may give rise to a claim?
Yes
No
Has any insurer declined a proposal or refused to renew insurance?
Yes
No
1. Please acknowledge that you have read and understood Graybrook Hallam Terms of Business Agreement and Privacy Notice
Yes
Please acknowledge that you have read and understood the policy terms and conditions
Yes
Please acknowledge acceptance of the following:
I declare that to the best of my knowledge or belief the particulars and statements given in this proposal and any other information provided in connection with this proposal are true and complete and this proposal, declaration and information shall be the basis of the contract between myself and the Insurer. I consent to the processing of any sensitive personal data in order to administer and underwrite this policy. I agree to accept the insurer’s standard form of policy and endorsements for this insurance. I confirm that all persons carrying out activities in accordance with the Business as defined above are suitably qualified to do so.
Yes
Important Information
Personal Data
The insurer for policies underwriting this scheme is Aviva Insurance Limited. The scheme is administered on their behalf by Graybrook Hallam.
To arrange and administer your policy Aviva Insurance Limited and Graybrook Hallam will hold and use information supplied by you, in accordance with U.K. Data Protection Laws and General Data Protection Regulation (GDPR). Full information and your rights about the personal data we collect and process can be found in our Privacy Notice which is available on request and online at www.graybrook.co.uk. A copy of the Privacy Notice will also be included in your quotation/renewal pack.
Graybrook Hallam would also like to send you details from time to time of their other related insurance products/services which may be of interest and benefit to you. Please select if you wish to receive such details by:-
Post
Email
Telephone
Unless you select one of these options we will not be able to send information on any of our other insurance policies or services.
We will not sell or pass your information to other organisations for marketing purposes.
CUE - Insurers pass information to the Claims and Underwriting Exchange register, run by Insurance Database Services Limited (IDS Ltd). The aim is to help us to check information provided and also to prevent fraudulent claims. When we deal with your request for insurance, we may search the register. When you tell us about an incident which may or may not give rise to a claim, we will pass information relating to it to the register. You can ask for more information about this.
IPT - Insurance Premium Tax
The Finance Act 1994 requires us to levy Insurance Premium Tax at the prevailing rate on insurance premiums. For further information, please ask us.
LAW APPLICABLE
The parties to the policy have the right to choose the law applicable to the Policy. Unless the parties agree otherwise English Law shall apply
The policy is administered By
Graybrook Hallam, 8 Chandlers Way, South Woodham Ferrers, Essex CM3 5TB
Web:www.graybrook.co.uk
Email:enquiry@graybrook.co.uk
Tel: 01245 321185 Fax: 01245 322240
Graybrook Hallam is Authorised and regulated by the Financial Conduct Authority. Registered No. 595238
and underwritten By
Aviva Insurance Limited
Registered in Scotland No 2116
Registered Office: Pitheavlis, Perth, Scotland PH2 0NH
Authorised and regulated by the Financial Services Authority
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