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In completing the questions and agreeing or disagreeing with assumptions during the quote process you are required to make a fair presentation of the risk to Insurers. This means that you must disclose every material circumstance which you know or ought to know relating to the risk to be insured. A circumstance is material if it would influence the judgment of a prudent insurer in determining whether to provide insurance for the risk and, if so, on what terms.

What you know: You will be expected to know any information which is known by individuals who are: (a) part of your senior management (i.e. individuals who play a significant role in the making of decisions about how your activities are to be managed or organised); (b) responsible for arranging your insurance (i.e. individuals who participate on your behalf in the process of procuring your insurance in any capacity).

What you ought to know: In addition, you are expected to know any information that should reasonably have been revealed by a reasonable search of information available to you (whether the search is conducted by making enquiries or by other means). This could include any information held within your organisation or by any other person.

Clear and Accessible disclosure: The disclosure you give must be made in a manner which would be reasonably clear and accessible to a prudent insurer.

Every material representation of a matter of fact which you make must be substantially correct and every material representation as to a matter of expectation or belief must be made in good faith.

Failure to comply with the duty of fair presentation could mean that the policy is void or that Insurers are not liable to pay all or part of your claim(s).

If you are in any doubt as to what may constitute a fair presentation, please feel free to contact us on 020 7234 4025 and we will endeavour to assist you.

For information on how we use your personal data please refer to our Privacy Notice.

Policy start date

What date would you like your cover to start or your current renewal date.

RequiredDate must be between 01/01/1800 and 31/12/2099 (inclusive)Invalid dateYour cover start date must be within the next 60 days

Your details

Are you applying as a company or an individual?

Company

Individual

Required

Business name

RequiredMaximum length of 120

Legal trading status

Required

Company Registration number

Maximum length of 20This is not a valid UK Company Registration number

Title

Required

First name

RequiredMaximum length of 40

Surname

RequiredMaximum length of 100

Postcode

RequiredInvalid postcode

Please select one of the following addresses:

Address

Address line 1

RequiredMaximum length of 160

Address line 2

Maximum length of 160

Address line 3

Maximum length of 160

City / Town

RequiredMaximum length of 160

County

Maximum length of 160

Email address

RequiredMaximum length of 60Invalid email address

Phone number

RequiredMaximum length of 60Invalid telephone number

We’d like to tell you about our products or services that may interest you. Please tick if you would like to hear about these by:

Telephone (live)

SMS

Post

We or our group companies may also send you details of the products and services of our group companies. Please tick if you would like to hear about these:

You can opt out of marketing communications at any time by contacting us.

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Arthur J. Gallagher (UK) Limited is authorised and regulated by the Financial Conduct Authority.

Registered Office: The Walbrook Building, 25 Walbrook, London EC4N 8AW. Company Number: 11931013 England and Wales.www.ajginternational.com

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