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ALLRISK Insurance
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QUOTE - PROFESSIONAL INDEMNITY
The Insured
Name of Business Entity
Business Trading Name (if applicable)
Email Address
Contact Number
How did you hear about Allrisk?
Business Address
Suburb
State
select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Business Details
State fully the Business Activity description
Are you qualified to provide the services described above?
select
Yes
No
Have you had more than 3 years experience?
select
Yes
No
Estimated Fee Income - this financial year
Fee Income - last financial year
Fee Income - the year before last
Do any of the following apply?
Are there any Partners Principals or Directors, after enquiry, aware of any Claim or has negligence been alleged, against the Insured or any of the present or former Principals, or have any circumstances which may give rise to a claim against the Insured or any of the present or former Principals?;
Has any Principal or staff member ever been subject to disciplinary proceedings for Professional Misconduct?; or
Are any of the principals, partners or directors aware, after enquiry of all staff, managers and contractors, of any accounts overdue for payment where there is reason to believe that the client is dissatisfied with the professional services rendered?
NO
YES
GET QUOTE
