01245 321185

Claims Made Professional Liability Insurance For Members Of Prospect

Date: 05/07/2020

Your Information
At least one of the proposer’s principals and other qualified personnel must have either:
• a minimum of 3 years’ relevant experience or
• a University Degree or a nationally recognised higher education qualification
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
The Employers PAYE reference number is usually in the format of either NNN/Aannnnn or NNN/Annnnn, where N/n is a number and A/a is a letter (e.g. 012/Ab34567)
Disclosure Declaration
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.
If yes, please state

If Yes, please provide the following details. Retroactive cover can only be considered when continuous Professional Indemnity Insurance has been held (please submit a copy of any current policy schedule showing the retroactive date application)
Please note that cover will not commence until this form has been received and accepted by Graybrook Hallam (unless otherwise agreed)
Important Notes
Important Notes:
• The Professional Indemnity cover provided by this policy is a) issued on a CLAIMS MADE basis which only covers claims notified to insurers during the currency of the policy and b) includes previous activities subject to previous continuously held Professional Indemnity cover.
• 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.
• The Public Liability section of this policy covers claims arising from incidents happening during the Period of Insurance.

DECLARATION AND UNDERTAKING I declare that every statement and particular contained within this proposal form:
which is a statement of fact, is substantially correct, and which is matter of expectation or belief, is made in good faith.

If any such facts, expectations and/or beliefs materially change before the insurance policy takes effect I undertake to provide details of all such changes to the Insurer in order to comply with my obligation to provide a fair presentation of the risk to be insured under the Insurance Policy. 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 or Occupation as defined above are suitably qualified to do.

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.