01245 321 185

BASRaT Members Application for £10M Increased Limits of Indemnity

Date: 16/10/2019

BASRaT Members Application for £10M Increased Limit of Indemnity
The Top-Up cover increases the individual limit of indemnity for each claim insured under the BASRaT members Block Professional Liability policy to £10M and is subject to the same policy terms, conditions and exclusions

Activities Insured
Only activities within the BASRaT role delineation/scope of practice will be covered by this insurance
This is an application to increase the limit of indemnity to £10 Million under the BASRaT Block Professional Liability scheme in respect of the above named member
All cover expires 31st January each year in line with the BASRaT Members Block Professional Liability Scheme
Bank Transfer

Please use your name or membership number as the payment reference

Name: The Medical Professional Liability Company Limited Sort Code: 60-95-44 Account Number: 39047562

Cheque

Cheques should be made payable to The Medical Professional Liability Company Limited and posted to Graybrook Insurance Brokers Limited, 8 Chandlers Way, South Woodham Ferrers, Essex CM3 5TB
Declaration
Your Duty of Disclosure
See attached leaflet on the changes introduced by the “Insurance Act 2015”. It is your duty to ensure sufficient information about your business is provided to insurers that enables them to understand the risks to be insured, or to make further enquiries. You may need to consult with others within your business who may also have relevant knowledge that should be declared to insurers. This duty continues throughout the lifetime of the policy when any change in circumstances should be notified.
Key Exclusions
This cover excludes the treatment of Professional Footballers.

Full details of the cover and terms may be viewed on our website www.graybrook.co.uk/basrat-topup

Please acknowledge acceptance of the following:

Important Information

Personal Data
The insurer for policies underwriting this scheme are certain syndicates at Lloyds of London via MPLC Ltd. The scheme is administered on their behalf by Graybrook Insurance Brokers Limited.

To arrange and administer your policy MPLC 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.

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

This Scheme 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: 01245321185 - Fax: 01245 322240
Graybrook Hallam is Authorised and regulated by the Financial Conduct Authority. Registered No. 595238


This scheme is underwritten by:
syndicates at Lloyds and administered on their behalf by MPLC Ltd licensed in Gibraltar by the Financial Services Commission under licence number FSC00659B