The Professional Indemnity Proposal Form is a fundamental document used in the Irish insurance market for businesses seeking professional indemnity coverage. It serves as the primary means of risk assessment for insurers and forms the basis of the insurance contract. The form must be completed by any professional service provider seeking protection against claims of professional negligence, errors, or omissions in their service delivery. The document complies with Irish insurance regulations and data protection laws, collecting comprehensive information about the business's activities, risk management procedures, claims history, and desired coverage levels. This information enables insurers to evaluate the risk profile accurately and provide appropriate coverage terms.
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1. Proposer Details: Basic information about the business/individual seeking insurance, including legal name, address, registration details, and contact information
2. Business Activities: Detailed description of the business operations, professional services provided, and geographical scope of operations
3. Financial Information: Revenue details, fee income, geographical split of revenue, and largest contracts
4. Risk Management: Information about quality control procedures, contract management, and risk mitigation measures
5. Claims History: Details of past claims, circumstances that could lead to claims, and any current insurance arrangements
6. Cover Requirements: Desired level of coverage, limits of indemnity, and any specific coverage extensions required
7. Staff Information: Details of qualified staff, experience levels, and professional qualifications
8. Declaration: Statement of truth and accuracy of information provided, signed by an authorized representative
9. Data Protection Notice: Information about how personal data will be used, stored, and protected in compliance with GDPR
1. Cyber Security Measures: Required for businesses handling sensitive data or providing IT services, detailing cyber security protocols and data protection measures
2. Contractors/Subcontractors: Needed if the business uses contractors or subcontractors, including details of their work and insurance arrangements
3. International Operations: Required for businesses operating across multiple jurisdictions, including details of overseas work and applicable regulations
4. Professional Memberships: Relevant for regulated professions, including details of professional body memberships and compliance requirements
5. Previous Insurance History: Optional section for detailed insurance history including any declined coverage or special conditions
1. Schedule of Named Insureds: List of all entities to be covered under the policy, including subsidiaries and trading names
2. Claims Experience Appendix: Detailed breakdown of claims history and circumstances for the past 5-10 years
3. Revenue Breakdown Schedule: Detailed analysis of revenue by service type, client type, and geographical location
4. Qualification Schedule: List of key staff members and their professional qualifications
5. Risk Management Procedures: Detailed documentation of risk management protocols and quality control procedures
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