Insurance Brokers Professional Indemnity Application

Introduction and Duty of Fair Presentation

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Thank you for your interest in Insurance Brokers Professional Indemnity Insurance. Our form typically takes just a few minutes to complete but you can easily save your progress and return to it at any time.

The person completing this application form should be authorised by the proposer to do so and should make all reasonable
enquiries to enable all the questions to be answered.

DUTY OF FAIR PRESENTATION OF RISK
You have a duty to make a fair presentation of the insurable risk to insurers. To comply with this duty, you must disclose all material information about the risk known by you, your senior management team and/or those responsible for your insurances in a way that is “reasonably accessible” to insurers (i.e. it must be clear and concise). You must also disclose any other information that you, your senior managers or your insurance team do not currently know, but ought to know following a reasonable search. If you are in any doubt as to whether or not information should be disclosed, we recommend that you disclose it.

Completing this application does not bind the proposers or insurers to enter a contract of insurance.

Data Protection Notice
Any information provided on this form, which may include sensitive data (e.g. medical history, criminal convictions,
age), will be processed by Champion Professional Risks in accordance with our Privacy Policy and will only be used
for the purposes of providing insurance cover and handling claims arising.
In the course of our duty as insurance brokers we may be required to provide such data to limited third parties
including Insurers and/or circumstance required by law. A copy of the form and any additional documents submitted
should be retained for your records.
Click HERE for full details of our Privacy Policy