Business Liability Insurance

Starting a New Business

If you own a business, you can be liable for damages or injuries to another person or property. Though liability insurance is mostly optional, you might want to consider it for your business if the likelihood of legal action is high.

Policy details
Policy period
From*
MM slash DD slash YYYY
To*
MM slash DD slash YYYY
Who are you insured with*
Insured details
Insured name*
First Last
Email*
Phone
Contact name*
Address*
Street Address Address Line 2 City State Postcode Country
CLAIMS HISTORY
Claims details (Within past 5 years)
Have you during the past 5 years had any insurance declined or any underwriting conditions or excesses imposed?*
- Yes
- No
Details*
Have you had any claims in the past 5 years?*
- Yes
- No
Claim Details*
Type of claim Amount
SITUATION
Situation Adreess*
Street Address Address Line 2 City State Postcode Country
Building Information
Type of building*
Year Built*
Walls*
If other, please specify*
Roof*
If other, please specify*
Floor*
If other, please specify*
RISKS
Coverage details
Building sum insured*
Contents & Stock Sum Insured
Theft of Money
Do you need cover for Glass*
- Yes
- No
Liability Sum Insured*
Business Interruption / Loss of income
Signature
This electronic signature will be treated the same as if signed personally.*
This is signature..
Name

Starting a New Business

Starting a New Business

Policy details

Policy period

Insured details

CLAIMS HISTORY

SITUATION

Building Information

RISKS

Signature

Insurance Quote

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Type of claim	Amount