Pen Underwriting Proposal Form printable pdf download

PROPOSAL FORM

Commercial Cleaners

Public Liability Insurance

Important Notices

Please read these Important Notices before completing the Proposal.

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 that 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 the insurer before you renew, extend, vary or reinstate a

contract of general insurance.

Your duty however does not require disclosure of matter:



that diminishes the risk to be undertaken by the insurer;



that is of common knowledge;



that your insurer knows or, in the ordinary course of his business, 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 his 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 its beginning.

Privacy

Pen Underwriting handles your personal information with care and in accordance with the Privacy Act 1988

and the Australian Privacy Principles.

We collect personal information about you to provide you with

insurance and insurance related services. We may disclose your personal information to third parties for the

purposes described in our Privacy Policy, including related entities, insurers, reinsurers, agents and service

providers, some of whom may be located in the United Kingdom and India. By asking us to provide you with

insurance and insurance related services, you consent to the collection, use and disclosure (including

overseas disclosure) of your personal information for the purposes described in our Privacy Policy. Where

you provide personal information about others, you represent to us that you have made them aware of that

disclosure and of our Privacy Policy and that you have obtained their consent. If you do not consent to

provide us with the personal information that we request, or withdraw your consent to the use and disclosure

of your personal information at any stage, we may not be able to offer you the products or provide the services

that you seek. For information about how to access and or correct the personal information we hold about you

or if you have any concerns or complaints, ask us for a copy of our Privacy Policy or visit

Complaints Handling

If you are dissatisfied with a decision Pen Underwriting makes, our service, the service of others we appoint to

discuss insurance matters with you, or a claim settlement, we have an internal dispute resolution process to

assist you. For further information, ask for a copy of our Complaints and Disputes Resolution Policy or visit

General Insurance Code of Practice

Pen Underwriting and Underwriters at Lloyd’s proudly support the General Insurance Code of Practice. The

purpose of the Code is to raise standards of practice and service in the general insurance industry. A copy of

the Code can be obtained from or from us upon request.

Further Information

Your insurance broker can assist you to complete this Proposal. If you have any questions or need further

information concerning your insurance, you should contact your insurance broker to assist you with your

enquiry. You should direct all of your correspondence to Pen Underwriting through your insurance broker as

he is your agent for this insurance.

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Pen Underwriting Proposal Form

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