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Marketing & Communications PI Online Proposal Form

Please complete every question BEFORE pressing 'ENTER' as this will submit the form to us. if you require assistance please call us on 0117 929 3344
Your Business
No Yes
No Yes

Do you undertake any work in relation to the following:

No Yes
No Yes
No Yes
No Yes
No Yes
Claims
No Yes
No Yes
No Yes
No Yes

Please advise details of your present insurance

Please advise your requirements

Attach additional information
If you would like to attach more information, please upload your file here.
Disclosure of Material Facts

IIt is essential that every Proposer or Insured when seeking a quotation, taking out or renewing an insurance, reveals to the prospective Insurers any material facts or information (including any material circumstances or change in circumstance) which might influence the judgement of Insurers in fixing the premium or in determining whether they will accept the risk. Failure to do so may render the contract of insurance voidable from inception at the option of the Insurers and enable them to repudiate liability thereunder. If you have any doubt as to what constitutes a material fact or circumstance, seek our advice.

Declaration

By submitting this form, I declare that the above statements and particulars are true, full enquiry having been made, and I have not omitted, suppressed or mis-stated any material facts and undertake to inform the Insurer of any change to any material fact. I understand that the information I provide will be used in deciding the price charged by the Insurer for the risk and whether the Insurer will accept the application. I further agree that this declaration, together with any other information provided shall be the basis of any contract between me and the Insurer.


By completing this form you are agreeing for us to respond to you by post, telephone or email as appropriate.


This website is operated by SBJ Professional. Any information which you provide may be used by SBJ for marketing purposes and to tell you about new products, services or events which may be of interest to you. Your data will not be disclosed to companies outside of the SBJ group.


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A copy of this application form will be emailed back to you once submitted and should be retained by you for your own records


 
SBJ Professional is a trading name of Bluefin Insurance Services Limited. Bluefin Insurance Services Limited is authorised and regulated by the Financial Services Authority.