Please list the professional services you provide and need to be covered by insurance
What is your action (error, negligence) can cause damage claims the insurance cover is needed?
How many years in business in the named activities?
Total number of employees
Number of licensed (Engineers, Architects) staff
Professional activities’ turnover (previous year, the forecast for this year and next year, €)
Please list the countries in which you perform professional services and the approximate percentage of your services provided in each one
List the work performed during the past 24 months (the project name, location, work content, turnover €)
Will you subcontracting Professional Services?
If yes, how many% of subcontractors’ work from the entire volume insured?
Do you want subcontractors are also to be considered as insured persons?
If yes, please list subcontractors
Please provide the following information about your firm's current Professional Liability Insurance Coverage ( Insurance Company, Limit of liability, deductible)
Do you want a retrospective insurance coverage?
If yes, then start date
During past years has any claim been made, or has negligence been alleged against you?
If yes, please describe (time, place, description of allegation, amount of loss)
Sum Insured (€)
Policyholder name
Policyholder identity number / registration code
Policyholder's e-mail and phone
Applicant’s contact details (name, e-mail, phone) *
Any other additional information that you wish to add
If necessary, add a file (for example, wording of insurance obligation)