Mining Professional Indemnity Insurance Quote

For Contractors working on mine sites and associated activities

Complete the following form, and our team will respond to you within 1 working day.

Your Details
Name *
Name
Phone *
Phone
Insured Details
Full names of all entities requiring cover, including trading names, and commencement date of business.
Business Address *
Business Address
Business Phone *
Business Phone
http://
Particulars of each person giving advice (including name, age, qualifications, and years of experience). Please email CVs through to admin@doringinsurance.com.au
Period, Limits and Excess of Insurance
Insurance cover required from: *
Insurance cover required from:
Insurance cover to cease: *
Insurance cover to cease:
For what Limit/s of Indemnity are quotations required? *
$
There will be a minimum level of uninsured excess. Is a quotation required with a voluntary excess to achieve a premium saving? Please select as appropriate: *
$
Business Description
Do you provide any reports or is any professional advice given? *
If 'Yes', please email a sample copy of report given to admin@doringinsurance.com.au
Is any of the work for which you are responsible subcontracted? *
Do you ensure that all subcontractors carry professional indemnity insurance? *
Have you entered into a written contract with the mine/s? *
If 'Yes' please email a copy of the Insurance section of the contract, plus any other section relevant to assessing the risk to admin@doringinsurance.com.au
Fee Income Information
Include description of professional services provided / Fees received last financial year / Fees received current financial year to date.
Claims / Insurance History
Are you currently insured for Professional Indemnity Insurance? *
If 'Yes' please provide the following information. If 'No', please proceed to insurance history section below
$
Retroactive Date
Retroactive Date
$
$
Renewal Date
Renewal Date
INSURANCE HISTORY
Additional Information
DECLARATION
Declaration for and on behalf of Named Insured *
I/We declare and warrant that after enquiry all statements and particulars contained in this proposal and addenda are true and that no information whatever has been withheld which might increase the risk of the Underwriters or influence the acceptance of this proposal and should the above particulars alter in any way I/We will advise the Underwriters as soon as practicable. I/We understand that failure to disclose any material facts which would be likely to influence the acceptance and assessment of the proposal may result in the Underwriters refusing to provide indemnity or voiding the policy in every respect.