Directors and Officers Insurance (D&O) Quote Form

Directors and Officers Insurance (D&O) Quote Form

Contact Name

Contact Number

Email Address

Registered Name

Postal Address

Registered Address (If different from the postal address)

Business Description

Business Sector

Cover Required

Directors and Officers Liability (included as standard)

Company Legal Liability (included as standard)

Optional covers: Employment Practices Liability:

Limits of cover Required

Type of Company/Organisation

Turnover/Income: What was your turnover or income in the last 12 calendar months?


General Questions

Have you been trading for at least 12 months?

Have you made any redundancies in the last 6 months, or do you plan to make any redundancies in the next 12 months?

Is your organisation regulated by the Financial Conduct Authority?

Do you use external Human Resources consultants or legal advisors to review all employment terminations?

Do you communicate written employment and grievance policies to all new and existing employees?

Other then directors, are all duties segregated so that duel controls exist on signing cheques above £2,500 and issuing Instructions for disbursement of assets or funds?

Do you have any assets in the United States of America (USA, or does your turnover or income include any turnover or income from the USA?

In the last 5 years, have there been any claims or investigations made against you, or against any director, trustees, officers or employees, that this policy might have covered if it had been in force?

After full enquiry, ar you or any of your director, trustees, officers or employees aware of any fact or circumstance that may lead to a claim under the proposed policy?

Have you previously held Directors and Officers liability cover?

If Yes - When did the previous cover start?

If your organisation is a private limited company, did you make a profit (that is, a net profit after tax) in the last 12 months or If your organization is a charity, club or association have you made a surplus (that is, your income was greater then your expenditure) in the least 1 of the last 3 years?

If your business is Residents Association/Committee, Residential Managing Agent or Residential property owners, How many flats/apartments/private dwellings do you own or manage?

Only answer the following four questions if you are a charity, club or association:

Do you have a positive net worth? (This is, your total assets are worth more then your liabilities)

Do you manage or supervise children or vulnerable adults?

Do you provide a certification, examination or regulation service of you members?

Do you provide a financial or legal advice fee?

If you have answered any of the yes/no questions in the above General Questions section above and it advises "details required", Please provide the full details in the box below.

Once submitted a member of our team will come back to you in due course. If this is urgent please call us on 01375 487373