• Disability Services Care Insurance

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  • Disability Services Care Insurance

    Please select the cover you need
  • Part A: Property and Income Protection

  • Breakdown of Mechanical and Electronic Equipment Section

  • Part B: General Liability

  • Part C: Organisation Liability

  • Part D: Personal Accident

  • Policyholder details

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  • Period of Insurance

    Required period of insurance

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  • Business Activities / Occupation

    Please provide a full list of the business activities of all entities to be insured by this policy.Please categorise these business activities based on their respective types, along with any advice provided.Indicate the approximate percentage of income derived from each category.
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  • People

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  • Financials

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  • History

    Previous Claims or Losses
  • The questions relate to all Sections of cover being requested under this proposal for insurance.

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  • Duty of Disclosure

    The following questions relate to all Sections of cover being requested under this proposal for insurance.
  • HAS YOUR ORGANISATION OR ANY OF ITS DIRECTORS / OFFICERS / EXECUTIVE MANAGERS / TRUSTESS:

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  • Information about your organisation

    The following questions relate to all Sections of cover being requested under this proposal for insurance.

  • Property Section

    Part A: Property
  • Property 1 details

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  • Property 2 details

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  • Property 3 details

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  • Policy Coverage

    Property Protection Section
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  • Money Section

    Only complete this section if Money Section is required
  • If different limits are required at each location, please specify below. Otherwise the standard limits will apply to each location.

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  • Breakdown of Mechanical and Electronic Equipment Section

    Cover A – breakdown of mechanical Equipment.
  • Breakdown of Mechanical and Electronic Equipment Section

    Cover B: Breakdown of Electronic Equipment
  • Optional Extensions

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  • Theft Section

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  • Contents and Stock

    Cover is available for unspecified items up to a value of $10,000 per item. If a higher limit is required per item, please note below.
  • Part B: General Liability

  • Labour Hire/Subcontractors

  • Events

  • Manufacturing

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  • Excluded activities include: motor races, motor rallies, motor speed tests, motocross, trail bikes, dune buggies, quad bikes, go karts, mountain biking, horse/pony riding, canyoning, caving, rifle/ firearms, paintball, skirmish and other forms of shooting, hang gliding, parachuting, para gliding, hot air ballooning, aerial activities, white water canoeing/kayaking/rafting (above class 2 rapids), water sports with power boards or water skiing, scuba diving, vertical and horizontal bungee jumping, gladiator games, abseiling, rock climbing, high ropes courses, trapeze, zip-lines, rock walls, martial arts, boxing, amusement arcades, parks or rides, commercial fairgrounds, bouncy/jumping castles and/or use of any other inflatable device, trampolining, fireworks or fire walking.

  • Policy Coverage

    General Public and Products Liability Section
  • Optional Extensions

  • SEXUAL ABUSE INSURANCE - OPTIONAL EXTENSION

    Supplementary Questionnaire
  • Important notices

    This questionnaire is for use when Sexual Abuse insurance cover is requested. Please read this section before completing this proposal

    In respect of this questionnaire:

    “Abuse” means any physical or nonphysical intentional action that harms or injures another person or other people.

    “Assault” means any action, threat or attempt of inflicting physical harm to or unwanted physical contact with another person or other people.

    “Sexual Abuse” means any abuse or assault of sexual nature, sexual molestation, indecent exposure, sexual harassment or intimidation.

    “Safeguarding” is protecting the welfare and human rights of people (particularly people that may be at risk of abuse, neglect or exploitation) that are connected with an organisation. The term Safeguarding has previously been considered in reference to protecting children or vulnerable adults, however Australian legislation has broadened the definition to include all people who due to their personal circumstances require additional protection.

    “Vulnerable people” can be any person with whom an organisation engages (clients, staff, contractors, volunteers, suppliers and other third parties). Vulnerable people have specific legislative and ethical protections relating to safeguarding over and above the overarching principle that all people must be protected from harm. Vulnerable people can include:

    • children and seniors;
    • people with impaired intellectual or physical functioning;
    • people from a low socio-economic background;
    • people who are Aboriginal or Torres Straight Islanders;
    • people with low levels of literacy or education;
    • people subject to modern slavery, which involves human exploitation and control, such as forced labour, debt bondage, human trafficking, and child labour.

    Against a background of greater public awareness concerning “abuse” the potential long-term consequences for survivors of abuse, increasing recourse to litigation, possible wrongful accusations, and retrospective legal changes insurer keep under review risk management procedures and our underwriting approach for sexual abuse cover.

    It is important to be aware that an incident today may give rise to a claim in perhaps 20 or more years’ time.

    With this situation, there are complex long-term “abuse” exposure issues for policyholders and insurers alike. Good risk management is seen as a major underwriting factor in the prevention of abuse and the damaging consequences of possible wrongful accusations.

    Depending upon the nature of an organisation, there are varying regulatory, compliance, and industry requirements relating to safeguarding vulnerable people and prevention of harm.

    Compliance with these provisions will help reduce risk, however, a key element to minimise the “abuse” risk is the ongoing adherence by policy holders and their employees, contractors and volunteers to good risk management practices.

    Safeguarding policies and procedures, including a Client Protection Policy, assist organisations manage prevention of harm to vulnerable people along with reporting of harm and are essential within good risk management frameworks.

    Crucial features of Safeguarding Policies and Procedures include:

    • That their provisions are embedded in the culture and day-to-day operation of the organisation at all levels with relevant formal training and refresher courses held at least every year.
    • An ongoing review of these policies and procedures (at least every year) so as to maintain current good practice standards in safeguarding procedures and observe any changes to legislation, industry standards, and community expectations.
    • The secure retention of all personnel employment, incident and investigation reports, liability insurance policies and other relevant incident-related correspondence. Such documents should be retained for no less than 50 years. The requirements of the current Privacy legislation should be observed in respect to documents containing personal data.

    Such action assists you to:

    • Protects vulnerable people.
    • Maintain the integrity of the organisation.
    • Avoid damaging allegations and possible litigation that can have a profound effect upon those involved.
    • Maintain an appropriate risk management program, fulfilling your obligation to take reasonable and appropriate measures to protect from harm all persons in your care and employment and/or other specific conditions in accordance with the terms of your liability insurance policy with insurer.

    The following Questionnaire draws attention to the most important features in Safeguarding and prevention of harm risk management. Upon receipt of the completed Questionnaire our underwriters will review your responses to determine your eligibility to obtain cover under the Sexual Abuse Insurance Optional Extension. If your responses meet our risk selection and acceptance criteria you will be provided with a quotation including full details of such terms.

    A special note relating to record keeping

    Incidents of abuse may only come to light after a long period of time, in some cases many years.

    The long-term security of relevant documents including your Safeguarding policies and procedures and your Public Liability Insurance Policy is of crucial importance should allegations of abuse arise. All such documents must be securely retained for a minimum of 50 years.

    Documents containing personal data (as defined in the relevant Privacy legislation) should be securely retained “for as long as necessary” (certainly from an insurance point of view no less than 50 years) to ensure that the documents are available in the event of an allegation of abuse arising.

    The individuals mentioned in the documents should be notified that information about them may be held for a long period of time as part of a Safeguarding and prevention of harm risk management program. This may be best handled by use of a general statement in employment contracts and your published service use/member information literature.

    In addition, storage provisions for all such documents must be arranged in the event the organisation ceases operations. Generally acceptable methods of storage in these circumstances would be at the office of a solicitor, accountant or at a professional secure storage company.

    A note regarding your duty of disclosure

    Answers to the following questions and information given assist insurer in the assessment of the risk. All relevant facts must be disclosed. Failure to do so may result in the insurance cover being inoperative. Relevant facts are those that would be likely to influence an insurer’s consideration of the risk. If you are in any doubt as to whether a fact is relevant it should be disclosed. You should keep a record of all information supplied to Insurer in connection with this insurance.

    Unless we specifically request, we do not require sight of your written Safeguarding policies and procedures. You may be currently developing or updating your Policy. If that is the case you must advise us that the policies and procedures are being developed or reviewed. Whilst we can assist with the structure of your Safeguarding policies and procedures, guidance upon protection issues specific to the nature of your organisation should be sought from relevant authorities, central bodies or associations.

  • Sexual Abuse Insurance

    Supplementary Questionnaire
  • 1. Applicant(s) Information

  • Insurer will rely on your responses to the following questions to determine your eligibility to purchase insurance cover for Sexual Abuse related claims against your organisation.

  • 2. Protection of Vulnerable People

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  • 3. Safeguarding Policies and Procedures

  • g) Do your policies and procedures include the following recruitment, screening, and selection requirements?

  • h) Do your policies and procedures include the following in respect of reporting and responding to complaints and/or reasonable suspicion* of sexual abuse?

    • police and/or other statutory authority/ies in compliance with mandatory reporting obligations and any other legislated responsibilities relevant to safeguarding and protection of vulnerable people, your occupation or industry; and
    • senior management/ executive/ board representative/s as identified in your policies insurer.
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  • vi. A process for dealing with alleged perpetrators of sexual abuse including:

    • the automatic suspension of an employee, contractor or volunteer from work or other duties within your organisation, if they are under any investigation (internally or by the police) for committing sexual abuse; and
    • the automatic termination of an employee’s, contractor’s or volunteer’s involvement with your organisation if found guilty of committing sexual abuse following an investigation or trial.

    *Reasonable suspicion means fair and practical reason to believe an incident involving sexual abuse has occurred based on either verbal communication, hearsay, rumour or observance of behaviour.

    4. Past Incidents of Sexual Abuse

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  • 5. Declaration

    I/We declare that as far as I am/we are aware the statements made by me/us or on my/our behalf and the information supplied in connection with this Questionnaire are true, correct and complete and that all reasonable and proper enquiries have been undertaken to ensure that no information relevant to insurer’s decision whether or not to offer to insure our organisation against legal liability for abuse, has been omitted from or not attached to this Questionnaire.

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  • Professional Indemnity Section

  • Activities

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    Prior Professional Indemnity Insurance

  • Management Liability Section

  • Insuring Clause

  • Entity reimbursement: (cover is mandatory when directors and officers taken) limits: limits will be the same as directors and officers

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    Prior Management Liability or Directors and Officers Liability Insurance

  • Part D: Personal Accident

  • Note: the policy limits the Capital Benefits for all Insured Persons under the age of 18 years or over the age of 75 years to $50,000 maximum.

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  • Creche & pre school to year 12 students

  • Adult students:

  • Student weekly bodily injury benefits:

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    Do any Volunteers, members and/or students engage in any of the following activities? If yes, please select which ones:

  • Declaration

  • I/We declare:
    a. The answers given and statements made are to the best of my/our knowledge true and correct, and that I/we have not withheld any information likely to affect the acceptance of this application or the terms on which it is accepted.

    b. I/We have read and understood the Important Notices set out in the proposal and I/we are authorized to make this proposal.

    c. It is agreed that the information contained in this proposal and any attachments will be the basis of the Community service organizations Insurance contract between the named organization and insurer and is subject to the terms, conditions and provisions contained in the Community service organizations Insurance policy underwritten by insurer.

    d. That the information supplied in this proposal to insurer for both the principal purpose of assessing this application for insurance cover and the secondary purpose of disseminating to the business entity information, notices and details regarding this insurance policy and services distributed or offered by insurer.

    e. That I/we have made all due enquiries necessary in order to comply with the Duty of Disclosure.

    f. That I/we have read ACS financial privacy policy and consent to the use, disclosure and obtaining personal information about the Insured for the purposes shown on the privacy statement.

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