Additional Contractor Liability Proposal Form (Page 2 of 4) in pdf

IMPORTANT NOTICES (Cont’d)

Claims Made Notice for certain Extensions

Certain extensions are provided on a ‘claims made’ basis. This means that where such an extensions/s applies, they will cover

you for claims first made against you during the period of insurance and notified to the underwriter during such period of

insurance.

These extensions do not provide cover in relation to:

Events which occurred prior to the period of insurance or such earlier retroactive date as may be stipulated in the schedule;

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Claims made against you after the expiry of the period of insurance even though the event giving rise to the claim may have

•

occurred during the period of insurance;

Claims where the possibility of the claim was intimated in any way prior to the commencement of the period of insurance;

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Claims arising from or attributable to any facts, circumstances or occurrences noted on the proposal for the current period of

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insurance or on any previous proposal or of which notice had been given under any previous policy;

Claims arising from or attributable to any facts, circumstances or occurrences of which you were aware and knew (or ought

•

reasonably to have realised) prior to the commencement of the period of insurance may give rise to a claim.

As explained above, these extensions, by their terms, do not provide cover for claims made after the expiry of the period of

insurance provided by these extensions.

Section 40(3) of the Insurance Contracts Act 1984 however provides that an underwriter is not relieved from liability under a

contract of insurance in respect of a claim by reason only that the claim was made after the expiry of the period of insurance

cover provided by the contract where the insured has given notice in writing to the underwriter:

of the facts that might give rise to a claim against the insured;

•

as soon as was reasonably practicable after the insured became aware of those facts, and

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before the expiry of the period of insurance.

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It is therefore important that you advise us of any circumstances that could result in a claim during the period of insurance to

protect your position in case the circumstances develop into a claim after the expiry of the period of insurance.

Returning this Form

After completion, please ensure that this form is returned to either the existing Insured or the insurance broker for the existing

Insured. Under no circumstances should this form be returned directly to Sterling Insurance Pty Ltd.

1. DETAILS OF THE EXISTING INSURED

(Note: Must be completed by the existing Insured, and NOT the Proposed Contractor/Subcontractor)

Please state the name of the existing Insured.

Company Name(s)

A.B.N.

Please state the Policy Number applying to the existing Insured:

2. EXISTING INSURED’S ACKNOWLEDGEMENT

(Note: Must be completed by the existing Insured, and NOT the Proposed Contractor/Subcontractor)

I/We

declare that the proposed contractor/subcontractor will exclusively be engaged by and work solely for us.

we will advise underwriters when the proposed contractor/subcontractor has ceased to be exclusively engaged by

and work solely for us.

authorise underwriters to review this form to consider including the proposed contractor/subcontractor under our

existing Liability Policy.

acknowledge that the underwriters and their agents reserve the right to decline this Proposal.

Existing Insured’s:

Signature:

Name:

Position:

Date: _____ / _____ / _____

Prop PL Contractor-Subcontractor - 2013-08-01

Page 2 of 4

Additional Contractor Liability Proposal Form Page 2

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