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  • CONTACT INFORMATION

  • INSURED

  • Business Structure:*
  • Do you have an ABN?*
  • GST Registered*

  • http://www.insuranceadviser.net/privacy/

  • DUTY OF DISCLOSURE

  • Your Duty Of Disclosure
    Before you enter into a contract of general insurance with an insurer, you have a duty, under the Insurance Contracts Act 1984 (Cth), to disclose to the insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer’s decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to the insurer before you renew, extend, vary or reinstate a contract of general insurance.

     Your duty however does not require disclosure of matter:

    •  that diminishes the risk to be undertaken by the insurer;
    •  that is of common knowledge;
    •  that your insurer knows or, in the ordinary course of its business, ought to know;
    • as to which compliance with your duty is waived by the insurer.

    Non-Disclosure
    If you fail to comply with your duty of disclosure, the insurer may be entitled to reduce their liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, the insurer may also have the option of avoiding the contract from its beginning.

    Statutory Liability Extension and Errors & Omission Endorsement is Claims Made Insurance
    The Statutory Liability and Errors & Omission is an Extension to the Policy and is ‘Claims Made’ insurance. This means that the extension covers you for any claims made against you and notified to the insurer during the period of insurance.

     This extension does not provide cover in relation to:

    • acts, errors or omissions that occurred prior to the retroactive date (if one is specified) in the policy;
    • any claim made, threatened or intimated against you prior to the commencement of the period of insurance;
    • any claim or fact that might give rise to a claim, reported or which can be reported to an insurer under any insurance policy entered into before the commencement of the period of insurance;
    • any claim or fact that might give rise to a claim, noted in this proposal or any previous proposal;
    • any claim arising out of any fact you are aware of before the commencement of the period of insurance;
    • any claim made against you after the expiry of the period of insurance.

    However, the effect of Section 40(3) of the Insurance Contracts Act 1984 (Cth) is that where you become aware, and notify us in writing as soon as is reasonably practicable after first becoming aware but within the period of insurance, of any facts which might give rise to a claim against you, any claim which does arise out of such facts shall be deemed to have been made during the period of insurance, notwithstanding that the claim was made against you after the expiry of the period of insurance.

    Your Duty of Disclosure requires you to tell us of any information that may affect our/an insurers decision to insure you.  Each person(s) or entity named as the insured has this duty of disclosure.  If you do not tell us about any information which may be relevant to accepting this insurance, this may result in the refusal or redirection of claims or the cancellation of this policy.

    I/We have read and agree to the above and by completing the following fields, declare that the information provided above and in all appending sections is true to the best of My/Our knowledge.  

  • POLICY REQUIRED

  • What type of policy do you need?*

  • HOLE IN ONE INSURANCE

  • Event Start Date:*
     / /
  • Event End Date:*
     / /
  • Have there been any hole in ones on this course in the last 5 years?*
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  • PRIZE INDEMNITY INSURANCE

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  • Only policies with the current or future dates can be processed.  We are unable to back date policies.  If immediate assistance is required please contact our office.

  • Has the event been held before?*
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  • Does this represent the full extent of your financial responsibilities?*
  • Can you confirm that all the necessary contractual arrangements will be put in place in a timely manner and these will be valid for the period of the Insured Event or promotion?*
  • Have you sought legal advice, whether in-house or independent, on the legality of the proposed event or promotion?*
  • Do You know of any matter, fact or circumstance, actual or threatened, that increases or could increase the possibility of a loss under this proposed Insurance?*

  • CANCELLATION & ABANDONMENT INSURANCE

  • Has the event been held before?*
  • If YES to above, was this previous version organized by the same organizers?*
  • Is any part of the event to be held outdoors or under canvas/marquee/other temporary structure?*
  • Would adverse weather cause any part of the conference/exhibition to not proceed?*
  • What it covers:
    Our Cancellation insurance automatically covers cancellation of events that are held indoors caused by adverse weather, but if you require cover for events or functions held outside or under marquees or other temporary structures due to adverse weather then this optional extension is required.

    Why it’s important:
    A storm occurring just before your outdoor event may leave you with no time to move the function indoors. This Adverse Weather extension is available for a small additional premium based only on the portion of the event budget at risk.
  • If so, is there an alternate venue available?*
  • Is the conference reliant on a particular speaker or person to attend for the event to proceed?*
  • What it covers:
    Cancellation of all or part of the event due to Non Appearance of a Key Person (such as a headline speaker) due to illness, injury, death or travel delay.
     
    Why it’s important:
    The success of some events relies solely on the appearance of a particular person or speaker and yet their health prior to the event is out your hands, as is any accident or travel delay that may prevent them from appearing. If your event falls into this category, it is vitally important you consider the additional risk the event faces and obtain a quote to cover such a scenario.  Please contact our office on 07 3123 6919 if you have any questions regarding Guest Speaker V Key Person.
  • Do you wish to insure for the additional costs of replacing key speaker(s) or person(s) due to non-appearance caused by illness, injury, death or unavoidable travel delay? Please note our policy automatically provides cover for “Guest Speakers”*

  • PROPERTY INSURANCE

  • Property cover to a limit of $150,000 is automatically provided under the Cancellation & Abandonment policy. 
  • Is this sufficient?*

  • MONEY INSURANCE

  • Money cover to a limit of $150,000 is automatically provided under the Cancellation & Abandonment policy. 
  • Is this sufficient?*

  • CLAIMS

  • Will all contractual arrangements necessary for the successful fulfillment of each event be made and confirmed in writing prior to the start of the event?*
  • Has the Event to be insured suffered any incidents in the past 3 years that could have resulted or did result in a loss which would have been covered under this Insurance?*
  • Have you ever had an insurance claim for any of the above types of insurance?*
  • Is the Insured aware of any matter, fact, circumstance or incident existing or threatened that could possibly affect the Event and which might result in a claim under the proposed Insurance?*

  • DECLARATION

  • You declare to the best of your knowledge and belief and having diligently made all necessary inquiries the information provided in connection with this proposal, whether in your own hand or not, is true and you have not withheld any material facts. If you fail to comply with your duty of disclosure, we may be entitled to reduce our liability in respect of any claim you make or we may be entitled to cancel the policy. If your non-disclosure is fraudulent, we may also have the option of avoiding the contract from its beginning, meaning that the policy would no longer be valid and we would have no liability to pay any claim. 

    NOTE: * A material fact is one likely to influence acceptance or assessment of this Proposal and the attached Appendices by us: if you are in any doubt as to what constitutes a material fact you should consult your Broker. It is understood that the signing of this Proposal does not bind you to complete or us to accept this Insurance, but you agree that, should a contract of insurance be concluded, this Proposal, Appendices and any supporting information shall be incorporated into and form the basis of the contract.

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