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Professional Indemnity

Please download the form and send it to us in order for us to get you a competitive quotation.

Professional Indemnity covers Professional Advice given to your clients by you. Every professional who provides advice and services has a duty of care to their clients. A breach of this duty can lead to a legal liability to compensate a client who has sustained a financial loss.

Name:
Establishment Date:
(dd/mm/yy)
Address
Details of all Principals, Partners or Directors
Name:
Age:
Name:
Age:
Name:
Age:
Total Gross Fees in last financial year:
£
Estimated Gross Fees for next financial year:
£
Largest Fee from any one client:
£
Full Description of Activities, with percentage breakdown (estimated if no historical date):
Details of the 3 largest contracts in the last 5 financial years (give details of current projects if new business): (Client,Description,Contract Value,Fee)
1:
2:
3:
Have any claims in respect of the risks to which this form relates ever been made against the business or any of the Principals, Partners or Directors?
(yes/no)
Are any of the Principals, Partners or Directors, AFTER FULL ENQUIRY, aware of any circumstances which might give rise to such claim?
(yes/no)
Has any proposal in respect of the risks to which this form relates ever been declined or has any such insurance ever been cancelled or renewal refused?
(yes/no)
If YES to any question, please provide details:
Other material information:
Does the firm currently hold Professional Indemnity Insurance?
(yes/no)
What Limit of Indeminity do you require?
£
Name of current insurers:
Name of your broker:
Renewal Date:
(dd/mm/yy)
Limit of Indemnity:
£
Premium:
£
Excess:
£
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We are Bridges Insurance Brokers Ltd. Trading as Bridge Insurance Brokers. Registered in England No. 1066
Bridges Insurance Brokers Limited is authorised and regulated by the Financial Services Authority.

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