01245 321185

Professional Liability Insurance for Members of the UK Strength & Conditioning Association

Date: 08/08/2020

Your Information
Activities you wish to Insure You must accurately describe and list below all activities for which you are qualified to undertake and for which insurance is required. You must also demonstrate you have successfully completed an appropriate and recognised course if requested for each activity listed and insert below the percentage of your total annual income against each activity declared
Important Note: No cover is available for Injection of Lipogems and Ultrasound Guided Stem Cell Injections
Important Note: No cover is available for acupuncture related to fertility treatment when undertaken by Physiotherapists

For each of the practitioners engaged in the business, please specify for each field both the number of PAYE employees and the number of self-employed practitioners:
*When Doctors or Nurses are declared, full details of their activities must be submitted before cover can be agreed
For each of the practitioners engaged in the business, please specify for each field both the number of PAYE employees and the number of self-employed practitioners
It is a condition of this insurance that all self-employed practitioners and sub-contractors engaged by your business must maintain Medical & Public Liability Insurance in their own name to the same limit of indemnity as you select for your own business. All therapists, whether employed or self-employed must be suitably qualified and maintain registration with HCPC or other statutory regulator where required.
Limits of Indemnity and Employers' Liability
This is an option you should consider if you engage employees, self-employed persons, volunteers (including students on work experience)
for whom you may be liable for any work-related illnesses or injuries.

If you have answered Yes to either the above, please state:
If yes, please note that the policy is only intended to cover all the above activities as ‘First Response’ only.
Disclosure of Fair Presentation
Your Duty of Disclosure

IMPORTANT NOTICE CONCERNING YOUR DUTY TO MAKE A FAIR PRESENTATION OF THE RISK
Before your insurance policy takes effect, you have a duty to make a fair presentation of the risks to be insured under your insurance policy. A fair presentation of the risk is one which discloses to the Insurer every material circumstance which you know of or ought to know of; or gives the Insurer sufficient information to put the Insurer on notice that they will need to make further enquiries for the purpose of revealing those material circumstances, which makes that disclosure referred to above in a manner which is reasonably clear and accessible to the Insurer; and in which every material representation as to a matter of fact is substantially correct, and every material representation as to a matter of expectation or belief is made in good faith.

A material circumstance is one that would influence the Insurer's decision as to whether or not to agree to insure you and, if so, the terms of that insurance. If you are in any doubt as to whether a circumstance is material, you should disclose it to the Insurer.
Please answer the following:
If you have answered “Yes” to any of the above questions, please provide details below
If you have answered “Yes” please confirm

Important Notes:
• This policy is issued on an OCCURRENCE basis which only covers claims arising from activities undertaken during the currency of the policy.

• Cover will not commence until this application has been approved and a Quotation issued and accepted.

• Policies will run for 12 months from the agreed start date.

• No activities undertaken prior to commencement of the policy is insured unless agreed and noted in the Retroactive Endorsement.
(Retroactive cover may be available subject to evidence of previous and continuous insurance)

Important Information Personal Data The insurer for policies underwriting this scheme is RSA Insurance Group plc. (RSA). The scheme is administered on their behalf by Graybrook Hallam. To arrange and administer your policy RSA 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.
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.
This scheme is underwritten by Royal & Sun Alliance Insurance plc and arranged by Graybrook Hallam 8 Chandlers Way, South Woodham Ferrers, Essex CM3 5TB Tel: 01245 321185 Email: enquiry@graybrook.co.uk Royal & Sun Alliance plc (No. 93792) Registered in England and Wales at St Mark's Court, Chart Way, Horsham, West Sussex, RH12 1XL.Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority Graybrook Hallam is a Trading Name of James Hallam Limited which is authorised and regulated by the Financial Conduct Authority (FCA) James Hallam Limited is registered in England. Registered number 1632840. Registered Office: 156 South Street, Dorking, Surrey RH4 2HF.