Professional Indemnity Page 2
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75. Prior corporate entity:
Has the name of the person, firm or incorporated body detailed in answer to Question 1 been changed, or has any other business been
purchased or has any merger or consolidation of your businesses taken place?
No
Yes
Please detail changes in chronological order.
6. Total number of:
a. Qualified staff – including Principals.
b. Other technical staff.
c. Non-technical staff (including administration staff).
Total of all staff
7. Are you a member in good standing of a professional association or society?
No
Yes
Please provide status of membership and the name of the association(s) or society(s).
Insurance History
8. a. Are you currently insured for professional indemnity?
No
Yes
Please complete the table below for the last 3 years.
b. If you are not, have you ever been insured for professional indemnity?
No
Yes
Please complete the table below for the last 3 years you were insured.
Name of Insurer
Period Insured
Sum Insured
Excess
9. Have you ever had an insurer decline a proposal, decline to renew, cancel your insurance, or imposed special terms?
No
Yes
Please provide details below.
Your Professional Activities
10. a. State fully the professional services provided by your business. (Please provide copies of any brochures or other documentation
which may assist CGU Professional Risks in gaining a better appreciation of the risk being proposed).
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Parent category: Business