::.Welcome to Goldlink Insurance.::

We Have added the following new products:
  *School Safety policy.
  *Travel & Tours Insurance.
* Hospitality Plus Insurance.
  *A re-branded auto Insurance
more

PROFESSIONAL INDEMNITY INSURANCE :::

PROFESSIONAL INDEMNITY PROPOSAL FORM

Every question must have a written answer. If a negative reply is intended put 'no' or 'none' where applicable.

(1) Name of Proposer (in full)

(2) Address

(a) Email Address

(b) Telephone

(3) Profession

(4) Of which Professional Association(s) are you a fellow or member

(5) How long have you been established in the profession?

(6) Have you previously held or do you now hold a professional indemnity?

(7)Give details of any claims made or initiated against you since you
became a member of the Profession

(8) Has any application for this type of indemnity been
(a) Declined? YES NO
(b) Subject to premium increase? YES NO

(9) Amount of Indemnity
(10) Period

DECLARATION: I/We declare that the statements/particulars in this proposal are true and that
I/We have not misstated or suppressed any material facts. I/We agree that this proposal together with any other information by I/We shall form the basis of any contract of Insurance effected thereon. I/We undertake to inform the insurers of any alteration to these facts whether occurring before or after completion of a contract of insurance.

**GET YOUR QUOTES NOW