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is a trading style of

Insurance2day
Insurance Services Ltd


Authorised and regulated by the Financial Services Authority


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ISSUE COVER REQUEST
Thank you for your interest in our Directors & Officers insurance scheme, to enable cover to be issued please complete your details below:
   
Company Name:
Contact Name (inc Title):  
Business Address:
Postcode:
Contact Number:
E-mail Address:
   
Can you confirm that you comply with all of the acceptance criteria detailed below:
   

Acceptance Criteria:

(If you do not comply with all or any of the criteria below please call Insurance2day on 01384 442 165 for details of other products which may be more suited to your requirements)  

You can confirm that the company, and any subsidiaries thereof:

• Is a UK registered private company with a turnover less than or equal to £10,000,000

• Has no assets in North America

• Has no previous claims or circumstances that may lead to a claim under this policy

• Is not involved in telecoms, IT, pharmaceuticals or bio-tech and is not a financial organisation

• Latest audited report and accounts show a positive net worth


If you have opted to add Company EPL cover, please confirm that the company, and any subsidiaries thereof:

• Has a written grievance procedure in place and has not been the subject of any Employment Practice claims

• Is not currently undergoing, or does not contemplate within the next 12 months any employee layoffs or early retirements

If you have opted to add Crime cover, please confirm that the company, and any subsidiaries thereof:

• Has no business activities outside the UK and is also not a legal partnership, a gambling establishment, a jeweller or precious metal dealer, an outsourcing company, a transit company or a cash carrying company

   
Please provide full details if you do not comply with the Acceptance Criteria
   
Directors & Officers Limit of Indemnity:
Confirmation of Annual Premium
Method of Payment
If Other, please give details
 
N.B. No cover is in place until payment is received and you receive written confirmation of cover.
   
Please press the submit button to request cover