Insurance Application Form Policy Wording
Insurance Application Form Policy Wording

Professional Indemnity Proposal Form for run off cover

  • IMPORTANT NOTICE TO THE APPLICANT

    ArchiTeam MEMBERSHIP DETAILS
    Membership runs from 31 May until 31 May each year.
    Annual Membership $308.00 (incl. GST)
    Joining Fee $60.50 (incl. GST)
    ArchiTeam Share $1 (one off payment)
    All Applicants must be a registered Architect or graduate in Architecture or a registered practitioner in an allied profession.

    CLAIMS MADE POLICY
    This policy is a claims made policy of insurance. This means that the policy covers you for claims made against you and notified to the Insurer during the period of insurance. The Policy does not provide cover in relation to:

    • events that occurred prior to the retroactive date, if any, specified in the Policy;
    • claims notified or arising out of circumstances notified under any previous policy (whether made or issued by the Insurer or any other insurer);
    • claims made against you prior to commencement of the period of insurance;
    • claims arising out of claims and circumstances noted on the proposal form for the current period of insurance or on any previous proposal form;
    • subject to what is said in the next paragraph, claims made after expiry of the period of insurance even though the event giving rise to the claim may have occurred during the period of insurance.

    However, where you give notice in writing to the Insurer of facts that might give rise to a claim against you as soon as reasonably practicable after you become aware of those facts but before expiry of the period of insurance, the policy will, subject to its terms and conditions, cover you notwithstanding that a claim is only made after expiry of the period of insurance.

    YOUR DUTY OF DISCLOSURE
    Before you enter into a contract of general insurance with an insurer, you have a duty, under the Insurance Contracts Act 1984, to disclose to the insurer every matter which you know, or could reasonably be expected to know, is relevant to the insurer’s decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to us before you renew, extend, vary or reinstate a contract of insurance.

    Your duty however does not require disclosure of a matter:

    • that diminishes the risk to be undertaken by the insurer
    • that is common knowledge
    • that the insurer knows or, in the ordinary course of business as an insurer, ought to know as to which compliance with your duty is waived by the insurer.

    NON-DISCLOSURE
    If you fail to comply with your duty of disclosure, the insurer may be entitled to reduce its liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, the insurer may also have the option of avoiding the contract from it’s beginning.

  • 1. Applicant Details

  • Full legal name of each current incorporated company, unincorporated business, trading name or entity to be insured:
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Registered architect/s to appear on the Certificate of Currency
  • 2. Main Contact Person Details

  • 3. Staff

  • 4. Details of Principal(s)/Partner(s)/Director(s)





  • Please Note: To be covered all Principal(s)/Partner(s)/Director(s) need to be current members of Architeam.
  • 5. Retirement / Non Practicing details:


  • Retired members and members who cease trading under registered business name, who held insurance through ArchiTeam for three consecutive years prior to retiring are eligible for the special ArchiTeam Run Off Cover.

  • Please provide details for the practice turnover for the last two years prior to retirement / business ceased operation was:
  • Drop files here or
  • 6. Risk Management

  • Note: ArchiTeam can provide a legally reviewed and formatted Client Architect Agreement, alternatively you must have your own agreement or contract legally reviewed at your own cost.
  • 7. Claims History

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • 8. Insurance History

  • Has the applicant or any proposed person or entity ever had a professional indemnity insurer:
  • 9. Any Additional Information you Wish to Provide

  • 10. DECLARATION

  • I/We declare and acknowledge that:
    • I/we have made due inquiry of our principals, partners, directors and employees concerning the questions asked within this proposal and have authority to sign this proposal on their behalf;
    • I/we have read and understood the Important Information of this proposal;
    • the statements and particulars in this proposal are true and correct;
    • this proposal along with any other information supplied by me/us shall form the basis of any policy entered into;
    • I/we understand that up until the policy is entered into, we must notify any change in the matters disclosed in this proposal; and
    • I/we will notify any material alteration to the matters disclosed in this proposal occurring after completion of the proposal.
  • Agreeing to the form does not bind the practice or Insurers to complete the insurance.
  • Please be patient when clicking SUBMIT. It may take up to 10 seconds to process.

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Insurance Application Form Retiring / Non Practicing Member Policy Wording
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By purchasing online:

•  You are expected to self-manage your policy.
•  There is no advice provided by Austbrokers Countrywide.
•  You will need to manage your own claims directly with Austbrokers Life Solutions by calling 1300 161 635.
•  If you need to make changes to the policy, you will need to contact Austbrokers Life Solutions on 1300 161 635.

CLICK TO CONTINUE

You are about to leave our site

By purchasing online:

•  You are expected to self-manage your policy.
•  There is no advice provided by Austbrokers Countrywide.
•  You will need to manage your own claims directly with CHUBB by calling 1800 803 548.
•  If you need to make changes to the policy, you will need to contact CHUBB on 1800 803 548..

CLICK TO CONTINUE

You are about to leave our site

By purchasing online:

•  You are expected to self-manage your policy.
•  There is no advice provided by Austbrokers Countrywide.
•  You will need to manage your own claims directly with CGU by calling 1300 306 083.
•  If you need to make changes to the policy, you will need to contact CGU on 1300 306 083.

CLICK TO CONTINUE

You are about to leave our site

By purchasing online:

•  You are expected to self-manage your policy.
•  There is no advice provided by Austbrokers Countrywide.
•  You will need to manage your own claims directly with CGU by calling 1300 306 083.
•  If you need to make changes to the policy, you will need to contact CGU on 1300 306 083..

CLICK TO CONTINUE

You are about to leave our site

By purchasing online:

•  You are expected to self-manage your policy.
•  There is no advice provided by Austbrokers Countrywide.
•  You will need to manage your own claims directly with CGU by calling 1300 306 083.
•  If you need to make changes to the policy, you will need to contact CGU on 1300 306 083..

CLICK TO CONTINUE