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Professional Indemnity Insurance Application Form

Miscellaneous Professions

This document can be used as a template for a Professional Indemnity Insurance Application Form. The form allows individuals to fulfill their duty of disclosure before entering into a contract of general insurance with an Insurer.

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Document Description

This document can be used as a template for a Professional Indemnity Insurance Application Form for all miscellaneous professions. The form allows applicants to fulfill their duty of disclosure before entering into a contract of general insurance with an Insurer.

How to use the document? 

This document should be carefully read by the applicant, and this proposal must be completed, signed and dated by a Principal, Partner or Director.

When filling the information, you must answer all the questions in this form. If a question is not applicable, state “N/A”.

If you are a new business, use the projected figures from your business plan.

This document should set out clearly the coverage of the insurance.

In addition to providing contact information, name, and occupation, the applicant also needs to provide signature.

 

 

 

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