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Professional Liability Insurance
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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 staff (engineers, architects, etc)
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 in €)
Are you or will you be subcontracting professional services?
Yes
No
If yes, which % of the subcontractors' work out of the entire volume do you need insured?
Do you want subcontractors to also be considered as insured persons?
Yes
No
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 retrospective insurance coverage?
Yes
No
If yes, then start date
During past years, has any claim been made, or has negligence been alleged against you?
Yes
No
If yes, please describe (time, place, description of allegation, amount of loss)
Sum Insured
Territorial scope of insurance cover
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)