Mining Liability Insurance Quote

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

Your Contact Details
Name *
Name
Phone Number *
Phone Number
Insured Details
Full names of all entities requiring cover including trading names
Business Commencement Date *
Business Commencement Date
Business Address *
Business Address
http://
Period and Limits of Insurance
Insurance cover to commence *
Insurance cover to commence
Insurance cover to cease *
Insurance cover to cease
on any one occurence
$
annual aggregate
$
$
Business Particulars
$
$
including earnings of directors and partners
$
Mining Specific Questions
(hard/soft)
Is any blasting or explosive work carried out by your or your subcontractors? *
Please list the relevant experience and qualifications of all persons employed or conducting work on behalf of the Insured, including number of years in this occupation (including Principals / Partners / Directors
Please enter the details regarding Mine Locations usually worked
(if applicable)
(if applicable), including approximate depth
Provide details of the personal protective clothing and equipment being used
Do you (employees or subcontractors) carry out any hot works? *
Do your hot works safety procedures comply with Australian Standards? *
Staff Training
Please provide details of staff training given to new employees
Please provide details of staff training given to existing employees
Subcontractors
Do you use subcontractors? *
$
Are subcontractors required to carry their own liability insurance
$
Do you always check the insurances of subcontractors?
Products
Do you manufacture, supply, distribute or sell any products? *
Please provide details on products, including their use, and the estimated turnover for the next 12 months
If your products are required to comply with Australian Standards or other Government regulatory requirements, please provide details.
USA and Canada
You will be asked to supply copies of all contracts in relation to exports to the USA or Canada.
Have you given Power of Attorney to any person or corporation in the USA or Canada? *
Do you have any assets/company located in the USA or Canada? *
Do you have any employees or other representatives in the USA or Canada? *
Contractural Liability
Have you entered into any contracts or agreements where you have assumed the liability of others or released others from liability (hold harmless)? *
NOTE: This insurance does not cover such liability unless agreed by the Companies. Please provide a copy of such contracts and agreements if cover is required. An extra premium will apply.
Use of Certain Machinery
Does your business use unregistered vehicles? *
Claims / Insurance History
Do you currently have insurance? *
During the past five years, have you ever had a claim made against you? *
Or are you aware of any incident, accident or prosecution which could lead to a claim being made against you (whether insured or not)?
Please provide details of date, particulars, cost, and name of insurer (if any)
Has any insurer ever declined indemnity for any claims made by you? *
Has any insurer declined, refused to renew, cancelled or imposed special conditions to any policy of insurance held by you? *
Statutory Liability, Enquiries and Reputation Cover
Do you require a quote for Statutory Liability, Enquiries and Reputation Cover?
Does the Insured have manuals and/or written procedures regarding compliance with all Acts of Parliament that govern the occupation?
Are these manuals regularly audited by external consultants to ensure compliance with the relevant Acts of Parliament?
Does the Insured have any professional and/or trade association membership?
e.g. Mine Managers Association of Australia
Does the Insured and/or any employees or third party contractors hold relevant qualification?
Including certificates of competency
e.g. tailings dams
In the last five years, and after specific enquiry of the Named Organisation, Management and Staff, has any proposed insured had a FINE or PENALTY imposed by Federal, State, Local Goverment or Regulatory Authority?
In the last five years, and after specific enquiry of the Named Organisation, Management and Staff, has any proposed insured had workplace or environmental incident that warranted investigation by a Regulatory Authority?
In the last five years, and after specific enquiry of the Named Organisation, Management and Staff, has any proposed insured had a COMPULSORY REQUIREMENT TO ATTEND any hearing, inquiry, prosecution or other commission?
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.