PracticeCover

Recent Practices

Full Name	Practice Name	Business Type	Status	Email

Quote Ref	Practice / Client	Type	Renewal Date	Status	Premium	Created

Step 1 of 7 — Client Details and Correspondence Address

1.1 Enter correspondence details for this policy or click 'Apply Customer Details'

* Mandatory fields

Apply from existing Practice record

Policy Information

Renewal Date *

Quote Type *

Previous Insurer *

Contact Details

Full Name *

Name of Contact

Telephone Number *

Mobile Number

Email Address *

Correspondence Address

Address Name / Number

First Line *

Second Line

Town *

County

Country *

Postcode *

Step 2 of 7 — Declarations

Please answer all declaration questions honestly and accurately

2.1 Select any of the following that apply to any proposer, director, partner, or any person with a financial interest in the business, if they have ever, either personally or in any business capacity

None of below

had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending

been declared bankrupt or insolvent, or been the subject of bankruptcy or insolvency proceedings

received a county court judgement in respect of debt, or entered into an individual or company voluntary arrangement

had an insurance proposal refused or declined, had insurance cancelled or its renewal refused, or had any special terms imposed

had any losses or incidents giving rise to losses in the last 5 years

become aware of any circumstances that could give rise to a claim in the last 5 years

2.2 How many years since last claim?

Years since last claim

Claim type	Date	Claim made	Description	Settled	Total

Step 3 of 7 — Cover Choice - Physical Items

Select the physical items cover options required for this policy

3.1 Physical Items

Do you require the inclusion of Day one cover (on all premises)?

This adds additional protection against inflation beyond the policy year

What excess is required?

This will apply to the cover for physical items & business interruption

3.2 Fidelity

Do you want cover for Fidelity?

Fidelity protects against theft of money & stock by employees.

When covered we offer a limits from £10,000 to £50,000

Step 4 of 7 — Cover Choice Continued

Assault and Employee Personal Accident cover details

4.1 Assault

A range of benefits are included for Bodily Injury caused by theft, happening in the course of The Practice

4.2 Employee Personal Accident

Cover is available to pay Compensation to You for a range of Accidental Bodily Injuries to an Insured Person.

The amount of compensation payable is selectable in units for each category of Insured Person.
You can either cover one or other of the Employee Types separately, or both.
Cover is for all of the people in the categories selected
Each unit is £5,000

4.3 Employee Type

	Number of Units	Full Time	Part Time
You, any director of Yours, or partner, or proprietor of The Practice
Any other Employee of Yours (aged 75 or under)

Step 5 of 7 — Business Interruption

Business interruption cover details for this policy

This protects damage to your premises due to an insured cause e.g. impact when a patient drives through the pedestrian entrance, destroying the foyer etc

There are two options for cover:

1- Loss of Income - replaces the money lost from not being able to operate

As standard we include cover for a loss of £500k over 24 months. This can be increased if needed.

2- Increased Expenses - provides money to pay for preventive measures so you don't lose money

5.1 What cover type is required:

5.2 What is the annual sum insured you want for all your premises on the policy (annual):

This cover is going to float across all your addresses

5.3 Our standard cover period is: 24 months If required: we can arrange cover for are: 12, 18, 24, 30, 36, 48, 60 months

A range of additional benefits are included for other events that can hinder the operation of the surgery.

5.4 How much cover is required for Outstanding Book Debt Balances?

Our minimum cover is £10,000

Step 6 of 7 — Public & Products Liability

Liability cover details for all premises on this policy

Cover for all premises:

6.1 What is the limit of indemnity do you want:

6.2 Do you run any offsite clinics? If so how many?

N.B. not visits to individual patients

6.3 Do you want cover for terrorism?

6.4 What is your anticipated turnover for the next 12 months at all premises?

Step 7 of 7 — Premises Details

Details of the premises to be covered under this policy

7.1 How many premises are you quoting for?

7.2 Country - all premises are in:

Premises Details

Complete details for each premises below

Status Address Progress Action

Premises 1

Complete all 8 sections for this premises

Full Name	Practice Name	Business Type	Status	Email	Telephone

Name	Email	Role	Status	Created

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