• Professional Indemnity for Pool Safety Inspectors

     

    This form is for Pool Safety Inspections only.

    Prefer to talk it through? You can call Liability Brokers during business hours to discuss your quote, or leave us a message in the Contact page.

  • Does Your business incorporate any prior trading entities?

  • Professional Duties
    We need to understand what you do in order to rate your risk

  • Do you hold the necessary qualifications required to perform all the services you have selected to be included in your cover?*

  • Sums Insured

  • Professional Indemnity*
  • Public Liability*

  • Underwriting Questions

  • Are you currently insured?*
  • Type of pools inspected

  • Locations of Work

  • Rows

  • NSW Small Business Stamp Duty Exemption

  • I declare that I/we are a small business eligible to seek a stamp duty exemption and have an aggregated turnover of less than $2 million.*

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    Notes:
    Aggregated turnover is your Australia wide annual turnover plus the annual turnovers of any business entities that are your affiliates or are connected with you.

    A fraudulent declaration may invalidate your insurance contract.

    The declaration covers all policies issued to you during the last financial year.

    An insurer will place reliance on your declaration in charging the applicable insurance duty

    False declarations may result in penalties up to $11,000 by Revenue NSW plus the Insurance duty not paid and penal interest on that balance.

    Revenue NSW may also be able to darify your queries relating to the law and your obligations.

     

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    Manual Risks

    Manual risk exposure involves:

    • Manual labour or manual tasks performed by yourself (apart from measuring).
    • The supervision of manual labour or manual tasks performed by other parties.
    • The responsibility of manual labour or manual tasks performed by other parties.
    • The training of others on how to perform manual tasks
  • Does your business involve Manual Risk exposure?*

  • Contractors

  • Do you employ contractors, sub-contractors?*
  • Do You require cover for sub-contractors?
  • If "NO", do You insist they carry their own insurance?

  • Insured's History

  • Have any claims been made in the last ten (10) years against this Business or any of its predecessors or any prior business of any of its former Partners, Principals or Directors, or have circumstances been notified to insurers that might give rise to a claim?*
  • Is any applicant aware of any claim or circumstances that might give rise to a claim against the Business or any prior business of any of their present or former Partners, Principals or Directors, which matter is not referred to above?*
  • Has any applicant ever been subject to disciplinary proceedings for professional misconduct?*
  • Has any applicant ever had a Liability Insurer decline to continue the applicant's insurance or cancel their insurance?*
  • Have you (or any person receiving cover under this policy) ever been involved in a company that has been declared bankrupt or insolvent or been liable for any civil offence or pecuniary penalty or been charged or convicted for any criminal offence including fraud, theft or dishonesty?*

  • Declaration

    By submitting this Declaration the Applicant acknowledges:

    • they are authorised by each of the other Applicants to make this Declaration,
    • the contents of the Declaration are true and complete,
    • they are under a continuing obligation to immediately inform the insurer of any change in the particulars or statements contained in this Declaration or in the accompanying documents up until the contract is entered into,
    • they authorise the insurer to give or obtain from other insurers or insurance reference bureaus or credit reporting agencies, any information about this insurance or any other insurance held by the Applicant/s.

  • Your quote has been sent to the email address provided. 
    Please refer to this email for instructions on how to proceed.

  • Should be Empty: