Physical Damage at the Premises (Fire/Flood etc)

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Inability to trade following Physical Damage:

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Inability to trade following Technology Collapse:

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Accidents at work causing staff illness or injury:

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Accidents involving injury, illness or damage caused by you to members of the public or third party property:

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Injury, illness or damage caused by products you sell:

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Disruption and inability to trade following a criminal cyber attack:

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Management failure in relation to Health and Safety, employment disputes or behaviour that causes shareholder reaction:

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The theft or misuse of your intellectual property:

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Being sued for a lack of provision of bad or negligent advice:

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Who is completing this Form:

Your Role:

OwnerPartnerDirectorSenior Management

Business Name:

Trading Name:

Phone number:

Email:

Correspondence Address:

Correspondence Postcode:

Risk Address (if different):

Risk Postcode (if different):

Company Registration Number:Not Applicable

Employee PAYE Reference Number:

From what date would you like the cover to start:

In which sector/industry is your business based:

What is the Legal Status of this business:

Please SelectConstructionFood, Drink & EntertainmentProperty OwnerManufacturingProfessionRetailServiceLandlordOther

Please SelectLimited CompanySole TraderPartnershipUnincorporated Association (i.e. Club or voluntary Group)LLP (Scotland)LLP Company

How long approximately has the business traded:

Years at this Risk Address:

Years at another address:

Has any insurer declined to accept, cancelled or refused to continue any insurance of this nature with the proposer:

YesNo

Has the Business ever been prosecuted under the Factories Act 1961, Health & Safety at Work Act 1974, the Consumer Protection Act 1987 or any other statutory regulations:

YesNo

Do you have a current insurance policy:

YesNo

Are there any incidents or losses that would give rise to a potential claim within the last five years:

YesNo

Has any Principal, Partner or Director or any senior management ever been declared bankrupt, or been in a business that has been sequestrated, liquidated or placed into administration:

YesNo

Has any Principal, Partner or Director or any senior management ever had an insurance proposal declined:

YesNo

Has any Principal, Partner or Director or any senior management ever been charged with a criminal conviction (excluding motoring convictions):

YesNo

Has any Principal, Partner or Director or any senior management ever been subject of a County Court Judgement an Involuntary Arrangement, a Company Voluntary Arrangement or a Sheriff Court Decree:

YesNo

Has any Principal, Partner or Director ever been subject to a recovery action by Customs and Excise or Inland Revenue:

YesNo

Has any Principal, Partner or Director ever been served with a prohibition or improvement order under health and safety legislation:

YesNo

Has any Principal, Partner or Director ever been disqualified from holding company directorship:

YesNo

Has any Principal, Partner or Director or any senior management sustained any insurable/ physical loss or damage during the last five years in a personal or business capacity in excess of £5,000:

YesNo

Has any insurer refused to continue, cancel or decline insurance cover for any Principal, Partner or Directors or senior management of the Business:

YesNo

Has any Principal, Partner or Director or Senior Management ever been convicted of or charged (but not yet tried) with arson or any offence involving dishonesty of any kind (e.g. fraud, robbery, theft or handling stolen goods):

YesNo

Are you the Sole Occupier of this Risk Address:

Are adjoining properties occupied:

Are there any unoccupied areas at the Risk Address:

YesNo

YesNoDon't Know

YesNoDon't Know

Has a Fire Risk Assessment been carried out on your premises:

YesNoDon't Know

Can you confirm if the premises have appropriate fire extinguishers:

YesNo

Do the premises have a sprinkler system:

YesNoDon't Know

Do the premises have a fire alarm system:

YesNoDon't Know

Do the premises have a smoke detection system:

YesNoDon't Know

Do you have a closing procedure:

YesNo

Have there been any cases of Flood at the premises or in the vicinity:

YesNoDon't know

What is the Roof made of:

What are the walls made of:

What is the floor made of:

TileSlateFlatThatchConcreteBitumen CoatedOther

Is any part of the roof flat:

YesNo

Age of premises:

No of storeys in total:

Storeys occupied by you:

Is the building:

Not ListedGrade 1 ListedGrade 2 ListedGrade A ListedGrade B ListedGrade C ListedUnknown

Is there composite panelling:

YesNoDon't Know

Are there any subsidence issues at the property or in the area that you are aware of:

YesNoDon't know

Is there is a basement:

YesNo

When was the electrical system installed:

Do you have a valid NICEIC electrical inspection condition report for your premises:

YesNo

Do you have a valid PAT test certificate for your premises:

YesNo

How are the premises heated:

Gas Central HeatingElectric fan heaterOil filled radiatorLPG gas heaterPortable paraffin heaterFixed open fire with flue

Are there any gas or paraffin portable heaters on the premises:

YesNo

Do your locks comply to British Standards 263 (BS263):

YesNoDon't Know

Final Exit Door

Yes

Yes

Yes

Yes

Yes

Yes

Rear Exit Doors

Yes

Yes

Yes

Yes

Yes

Yes

Fire Door

Yes

Yes

Yes

Yes

Yes

Yes

Windows

Yes

Yes

Yes

Yes

Yes

Yes

Is there a fire resistant cabinet in the premises:

YesNoDon't Know

Is there a burglar alarm installed on your premises:

YesNo

Is there a CCTV system fitted to the premises:

YesNo

Is there an external local authority CCTV system monitoring the vicinity:

YesNoDon't Know

How often is waste removed from the premises:

MonthlyFortnightlyWeeklyDaily

How far from the premises is the waste stored:

Is the removed waste kept in metal containers:

YesNo

Are all refrigerated units subject to an annual insurance maintenance contract:

YesNo

Is cash kept on the premises:

YesNo

Is Money moved between your premises and the Bank:

YesNo

Do you take cash home:

YesNo

Do you have a safe:

YesNo

Do you use forklifts:

YesNo

Are there any manufacturing processes carried out on the premises:

YesNo

Are there any flammable oils or other hazardous goods stored or used on the premises:

YesNo

Does your business involve the use of Frying and Cooking Equipment:

YesNo

Do the business hold an alcohol license to operate:

YesNo

Do you ensure that anyone working on your premises has at least a £5 million limit of indemnity on their public liability insurance:

YesNo

Do your activities expose your employees to any of the following: excessive noise, working at height or depth, power driven machinery or heat work:

YesNo

Do you collect or deliver stock:

YesNo

Do you:

ImportExportBothNeither

Does your business result in any impairment of the environment e.g. chemical effluents, fumes etc:

YesNo

Does your business involve the use of toxic and/or hazardous goods, materials, substances and/or waste:

YesNo

Have you ever been fined/ cautioned/ prosecuted by any environmental agency:

YesNo

Do you require insurance protection for the financial consequences of a data loss/breech (Cybercrime):

YesNo

Are you registered for VAT:

YesNo

If yes, you need not include VAT in the Sums Insured, but if you do 20% is a good cushion against uncertainty.

The Buildings at the risk address

Almost always insured by the owner for the cost of rebuilding including demolition, professional fees, and public authority upgrades

Landlords Loss Rent

Covered in the owner’s policy and on a standard lease usually for 36 months, most often paid by the tenant as part of the lease agreement.

Period of Loss Rent Period

12 months24 months36 months

Tennants Improvements

The cost of making additions or alterations to the Landlord’s Building that would remain to be inherited by the landlord at the end of the lease

External fixed Signage

Signage is expensive and vulnerable to weather and malicious damage, It should be insured for the full cost of replacement

Contents Items (Excluding Stock)

Machinery, Plant & Equipment

It is important to remember that we need to replace & the equipment as new. It’s the replacement cost on current specification, not the ‘book value’ that’s important

Fixtures & Fittings

This is a mixture of contents and fixtures which you would be able to remove if you were leaving the premises. Items like shop fitting, fixed seating can fall between here and Tenant’s Improvements. Thought required!

Computers & Electronic Hardware

The cost of replacing the equipment, as new. The big & issue here is loss of data and other cyber consequences, but that’s another discussion we need to have Want to have that discussion ?

Discuss Cyber & Data Protection

Portable Devices each individually under £2,000 in value

The cost of replacing as new. This goes beyond phones/laptops – think about specialist equipment you take out of the business.

Stock

Stock of Alcohol

The wholesale purchase price

Stock of Tobacco

The wholesale purchase price

High Value attractive Stock

Stuff that people would break in for.

Stock in the Open

Stuff that people would climb into the yard for

Chilled & Frozen Foods

You’ll need a maintenance contract to get a claim paid if it’s a breakdown of the cabinet or refrigeration.

All other Stock

Everything that’s not any of the above.

Business Interruption

For Businesses that Are premises dependent

Annual gross profit: (there is no universal definition for gross profit but if you want the wages paid go with Bob's tips)

This is the gross margin on turnover less cost of sales (usually stock). Not to be confused with Net Profit. The sum insured should look forward to project the trend, not look backwards. Most disastrous business insurance claims are associated by being under insured or for too short a period of interruption. (Except in exceptional circumstances the period should not be less than 24 months probably 36 months)

Number of months covered

6 Months12 Months24 Months36 Months

For Businesses that are Not premises dependent

Annual increased cost of working:

for businesses where turnover is earned ‘away’ from the premises and short term relocation expenses are more appropriate as turnover is less likely to be affected..

Number of months covered

12 Months18 Months24 Months36 Months

Money

On the premises during business hours:

If the premises were, say held up

In the premises outside business hours:

Contained in locked safes or strongrooms

In the premises outside business hours: but Accessible (in the till)

Leave the tills open, thanks!

At a private residence:

Some people take money home. Not Recommended. Cover is usually limited to £250

In gaming, amusement or vending machines:

First, Check who is responsible for the machine & the money

Cash In Transit

From the premises to the bank:

That’s literal. Don’t go anywhere else. Don’t carry more than £2500.00 in cash per person. Take more people or go more often.

Loss of License

Reduction in value of the premises

as a result of losing an alcohol license, Breweries and Landlords often insist on this, We've never seen a successful claim in 40 years.

Reduction in Gross Profit

as a result of losing an alcohol license this makes more sense, though it's hard to claim as the kind of stupidity that would lead to a claim is routinely excluded from cover. Although we've never seen a successful claim, it is possible, however, so should be considered a risk.

All Risks Specified Items

This would comprise items taken outwith the premises that are individually worth more than £2,000

Item Name

Item Value

Item Description

Activity

Number

Wageroll

Number

Wageroll

Clerical, Non Manual & Managerial

Stewards

Delivery Drivers

Woodworking Machinists

Working at Height (on or above 10 meters)

Working at Depth (at or below 1 meter)

Working with Hazardous Substances (e.g. Asbestos)

Naked Flame & Heat Work

Power Driven Machinery

Other Manual labour

Payments to Bona Fide Sub Contractors

Payments to Labour Only Sub Contractors

Turnover:

Annual Turnover and/or fee income of the business in the last 12 months

Projected Turnover:

Projected Annual Turnover and/or fee income of the business in the next 12 months

Turnover at premises: (%)

Turnover away from premises: (%)

Airports/Airside (%)

Railways/Trackside (%)

Power Stations (%)

Employers Liability Cover:

£10 Million£5 Million£20 Million

£10 Million is the minimum, only multinationals and big contracts require more

Public Liability Cover:

£5 Million£10 Million£15 Million£20 Million

£5 Million is normal, only those with increased exposure or contract require more

Products Liability Cover:

£5 Million£10 Million£15 Million£20 Million

£5 Million is minimum exports to North America may need more

Management Liability Cover:

£100k£250k£500k£1million

What is the maximum exposure for management misbehaviour?

Cyber Liability Cover:

£250k£500k£1million£5million

If you lose Data, how much else could you lose?

Professional Indemnity Cover:

£250k£500k£1million£5million

Think, whats the most you could be sued for?

Policy Excess

The amount below which you cannot or will not make a claim for reasons of economy and cost of processing.

If you would like to have a premium reduction what amount would you consider increasing your excess to:

£1,000£2,500£5,000

Have colleagues contributed to the completion of this Risk Presentation Proposal:

Yes

I confirm that I am duly authorised by the Proposer to make this declaration.

Signature:

Printed Name:

Position:

Date: