• Management Liability Proposal Form

  • IMPORTANT NOTES

    Who can use this proposal form? This proposal form is only for UK Private Limited Companies and Non-Listed PLCs, LLPs, Partnerships, Sole Traders, Charities, Clubs, and Associations. 

    This proposal form must be completed and signed by a Principal, Partner or Director of the Proposer/s. The person completing and signing the proposal form should be authorised by the Proposer/s to do so and should make all necessary enquiries of his fellow Partners, Directors and Employees to enable all the questions to be answered.

    All questions must be answered to enable a quotation to be given.

    Completing and signing this proposal form does not bind the Proposer/s or Jensten Insurance Brokers to enter a contract of insurance.

    If there is insufficient space to answer questions, please use an additional sheet and attach it to this form (please indicate section number).

    A copy of this proposal form should be retained by you for your own records.

  • Your Details

    Your business

  • Your Details

    Your business (continued)

  • Your Details

    Your Cover
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  • GENERAL QUESTIONS

    Depending on your answer to these questions you may be asked to provide more information.

  • Limits of Cover and Premium Indication

  • Your Premium Indication

  •  

    Flex your levels of cover

     Directors's and Officers' LiabilityCompany Legal LiabilityEmployment Practices Liability
    Cover level selected

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    You can speak to your adviser about flexible options for your cover limits. In some cases, reducing the level of cover in one area can reduce your overall premium. Please speak to your adviser to find our more.

    IMPORTANT!
    The Premium indication excludes taxes and fees. Your cover will only start when Jensten Underwriters Limited accepts your proposal. Your Jensten Insurance Brokers will confirm cover with you

  • We can't provide you with a Premium indication right now your answer(s) require us to review your proposal form. Please complete this form and send your proposal to your Jensten contact, and they'll refer you to Underwriters.

  • Please note: If you have had to provide further information to any of the previous questions, we will need to consider the information you have given us before we can confirm your premium and excess levels. This means that your premium and excess levels may be different from those shown below. Our terms of cover may also be different. 

    The compulsory primary cover is D&O, and to this either or both Company Legal Liability and Emplyment Practices cover can be added. The limit of indemnity on these additional sections can be less than or equal to the D&O section but not in excess of it.

  • Declaration

  • If you have not given full and true answers to all questions asked on this proposal form, your insurance may not protect you in the event of a claim.

    Jensten Underwriting Limited is part of the Jensten Group of companies which takes your privacy very seriously. For details of how we use the personal information we collect from you and your rights please view our privacy policy at https://jensteninsurance.co.uk/privacy-notice. If you do not have access to the internet please contact us and we will send you a printed copy.

    Please read this declaration carefully and then sign below

    • I/W e understand that all relevant information , which is information that may influence AXA Insurance UK plc in the acceptance of this insurance and the terms provided, has been disclosed and recorded
    • I/We declare that all particulars given in this proposal form whether made by me/us or on my/our behalf are true and complete.
    • I/We understand that if full and true answers have not been given or if all relevant information has not been disclosed that this insurance may not protect me/us in the event of a claim.
    • I/We will tell you of any change to the details given before the start date of the contract.
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