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Employer Protection Scheme

What will be the cost for my business?

Please complete this questionnaire to enable us to provide you with an idea of the cost of the package for your business. There is no obligation for you to proceed witht he terms indicated. A firm quotation can only be provided upon receipt of the proposal form. Please note that, upon assessment of the proposal form should the information be materially different underwriters may change the terms or premium indicated at this stage.

Name of business

What is the nature of the business?

Please confirm the current annual wage-roll for all members of staff, net of Employer's National Insurance and Pension Contributions (this amount should include all Partners and Directors)

How many people does the business employ full time and part time?

Has the business been subject to any employment law claims within the last three years? Yes No if yes, please confirm the numbers and details

Is Health & Safety Criminal Prosecution Cover required? Yes No

Please identify the Indemnity Limit required £50,000 any one claim
£500,000 in the aggregate £100,000 any one claim
£1,000,000 in the aggregate

Please advice what policy excess would be required £500 £1,000 £5,000 Other Amount
£

Contact details