The Insurance Proposal Form is a fundamental document in New Zealand's insurance industry, serving as the primary means of gathering information for risk assessment and policy issuance. This document is used when an individual or organization seeks new insurance coverage or wishes to renew existing policies. The form must comply with New Zealand's legal framework, including the Insurance Law Reform Act 1977, Privacy Act 2020, and Fair Trading Act 1986. It captures crucial information about the proposed risk, including business operations, risk management practices, claims history, and other material facts that could influence the insurer's decision to provide coverage and determine appropriate terms and conditions.
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1. Proposer Details: Basic information about the applicant including full legal name, trading names, contact details, and business structure
2. Privacy Statement: Mandatory statement explaining how personal information will be collected, used, and protected in accordance with the Privacy Act 2020
3. Risk Details: Core information about the risk to be insured, including location, nature of risk, and basic operational details
4. Claims History: Disclosure of previous claims, incidents, or circumstances that could give rise to claims
5. Risk Management: Information about existing safety measures, security systems, and risk mitigation procedures
6. Insurance History: Details of current and previous insurance arrangements, including any declined coverage or special conditions
7. Material Facts: Section for disclosure of any other material facts that could influence the insurer's decision
8. Declaration: Formal statement confirming the truth and completeness of information provided, including duty of disclosure acknowledgment
1. Business Activities: Detailed section for commercial insurance proposals, including business operations, turnover, and employee details
2. Property Details: Specific section for property insurance, including construction details, occupancy, and protection measures
3. Professional Services: For professional indemnity insurance, detailing services offered, qualifications, and risk management procedures
4. Vehicle Schedule: For motor fleet insurance, including details of all vehicles to be insured
5. Directors and Officers: For D&O insurance, including details of company structure, directors, and corporate governance
6. International Operations: For businesses operating internationally, detailing overseas exposures and operations
7. Cyber Security: For cyber insurance, detailing IT systems, security measures, and data handling procedures
1. Asset Schedule: Detailed listing of assets to be insured, including values and specifications
2. Claims Experience Appendix: Detailed breakdown of claims history for the past 3-5 years
3. Risk Survey Reports: Any pre-existing risk survey reports or assessments
4. Financial Statements: Recent financial statements where relevant to the risk assessment
5. Site Plans: Property layouts and site plans for property insurance
6. Security Certificates: Copies of relevant security, safety, or compliance certificates
7. Supplementary Questionnaires: Additional specific questionnaires for particular types of coverage or risks
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