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Insure
Insurance for Charities and Voluntary Organisations.
Assumptions
Statements
The quotation will be provided subject to the following statements:
1. No director or trustee in the charity/organisation has been:
convicted or charged with, or received a caution for any criminal offence other than a motoring offence;
declared bankrupt or had any unsatisfied County Court Judgement.
2. No Insurer to your knowledge has:
declined a proposal or refused to renew a policy; increased the premium on renewal, imposed special conditions or requested extra precautions to be taken (e.g. safety, security or fire requirements).
Please ensure that all information you provide is correct and that you answer all questions accurately. These details will form the basis of the insurance policy and any incorrect information could invalidate all or part of the insurance contract.
Please indicate your agreement with the assumptions above
General and Contact Information
Name of Organisation (Full legal title)
Name of Contact Person
Telephone
Mobile
Contact Address
Postcode
Email
About the Organisation
How many years has the charity been established?
On what date do you require the insurance to start?
Website
Your charitable status
Registered Charity
CIO
Not for profit organisation
Voluntary Organisation
Applying for charitable status
Other (please describe below)
Other charitable status
Charity Registration Number
Organisation/Charity's registered address
Postcode
List your current charity activities
Please give full details of all activities undertaken including any high risk activities such as "skate parks, rock climbing or water sports" and fundraising activities
Buildings
Describe the ownership of your building
Buildings cover required?
Yes
No
Rebuilding Sum Insured (ie cost of totally rebuilding including professional fees)
Risk address
Postcode
Are the buildings built of brick, stone or concrete block and roofed with tiles or slates?
Yes
No
Details of construction
Age of buildings
Is your property in a good state of repair?
Yes
No
Describe the current state of repair
Is building listed?
No
Grade 1
Grade 2
Grade 2*
Scotland - Grade A
Scotland - Grade B
Is your property used only for charity activities:
Yes
No
Do you loan, hire or rent your premises to any other organisations, groups or individuals?
Yes (please describe below)
No
Details of loaning or hiring arrangements
Subsidence cover required?
(usually only available if built since 1980)
Yes
No
Terrorism cover required?
Yes
No
Contents of the building
Contents cover required?
Yes
No
Value of General Contents
Value of Electronic equipment: computer, audio, video, PA equipment
Value of Musical equipment
Value of Stock in a bookshop, cafe, community facility eg foodbank run by you
Tenants Improvements Sum Insured
All risks
Cover for items taken out of the premises
Specified Items
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Remove
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Remove
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Remove
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Remove
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Description
Location
Select one...
British Isles
Worldwide
Own Premises
Sum insured
Add another item
Sum insured for unspecified property
Total value
Select one...
British Isles
Worldwide
Own Premises
Maximum any one item
Business Interruption Insurance
Do you require Interruption Insurance?
Yes
No
Total cover required if in excess of £25,000
Loss of income (limit required)
Extra expenses (limit required)
Gross profit (limit required)
Rental income (limit required)
Indemnity Period
12 months
24 months
36 months
Liability Insurance
Estimated gross annual income
Number of active volunteers
Clerical and Administration Duties
Full time
Part time
Manual
Full time
Part time
Number of employees
Clerical and Administration Duties
Full time
Part time
Manual
Full time
Part time
Estimated annual total payroll (if any)
Clerical and Administration Duties
Full time
Part time
Manual
Full time
Part time
Type of manual work
Is employer’s liability cover required? (Normal standard £10m)
Yes
No
Is Public, Products and Property Owners Liability required?
Yes
No
Please confirm the Level of Public Liability Insurance required (we recommend a minimum level of at least £5M)
£2,000,000
£5,000,000
£10,000,000
Do you work with children/vulnerable adults?
Yes
No
Do you have a Safeguarding policy in place?
Yes
No
Any other comments or any special requirements.
Other Cover and Details
Money + Personal Accident Assault
Maximum cash in transit:
None
£3,000
£5,000
Other (please specify below)
Maximum cash in safe:
None
£5,000
Other (please specify below)
Personal accident:
None
£10,000
£20,000
Other (please specify below)
Fidelity Guarantee:
None
£10,000
£20,000
Other (please specify below)
Computer Breakdown:
None
£10,000
£20,000
Other (please specify below)
Boiler and heating cover for sudden and unforeseen damage:
None
£10,000
£20,000
Other (please specify below)
Lift or other plant (Detail make, model, capacity and cost):
Trustee Indemnity (level of cover required):
None
£100,000
£250,000
Other (please specify below)
Professional Indemnity (level of cover required:
None
£250,000
£500,000
£1,000,000
£5,000,000
Other (please specify below)
Legal Expenses required?
None
£100,000
£250,000
Other (please specify below)
History
Are you now or have you previously been insured against any of the risks proposed?
Yes
No
Existing Insurer
Policy Number
Current Premium
Any terms applied?
Claims/Incidents History
Details, including cost, circumstances and dates of any loss, damage or liability incurred whether insured or not in the last 5 years
Long Term Undertaking required?
No
Yes - 3 years
Yes - 5 years
Date of expiry of current LTU
Further Information
Where did you hear about us?
Please ensure that all information you provide is correct and that you answer all questions accurately.
These details will form the basis of the insurance policy and any incorrect information could invalidate all or part of the insurance contract.
I confirm that I have given the correct information on this form
Thank you! Your submission has been received!
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