Ladbrook TAROE Insurance Scheme

STATEMENT OF FACT

Please complete & submit the following details in order for us to provide you with a quotation.

Full name of Organisation/Association:

Correspondence address:

Postcode:

Full contact name:

Telephone number:

Email address:

Period of insurance from (date):

Number of Members: Up to 25 Up to 50 Up to 100 Up to 250 Up to 500 Up to 1000 Up to 1500 Over 1500

Cover required

Hovering your mouse over an will give you information about the cover.

Public Liability Public Liability Insurance
Protects an organisation should a member of the public or any other third party suffer damage to property or injury to their person due to the negligence of any member of the organisation and who may then decide to sue the organisation for compensation. - Compulsory

Limit of Indemnity Limit of Indemnity
An indemnity limit is the level of cover required by an organisation, and is the maximum amount paid out by an insurer in the event of any one claim. required by you: £1 million £2 million £3 million £5 million

Employers Liability Employers Liability
If an organisation has any paid employees then it is a legal requirement that they take out Employers Liability Insurance.
It can also be argued that organisations that "employ" volunteers on an unpaid basis should consider Employers Liability Insurance.
Some insurance companies consider a volunteer to be an unpaid employee.
Employers Liability protects an organisation should an employee/volunteer suffer an injury during the course of their work and feel the organisation was negligent in causing the injury.
The employee/volunteer may decide to sue the organisation for compensation. - Optional, Cover required:  Yes No

Number of Employees/Volunteers: Up to 25 Up to 50 Up to 100 Up to 250 Up to 500 Up to 1000 Up to 1500

All Risks All Risks
All Risks relates to equipment purchased by an organisation, but that would be used/stored away from the premises used i.e. Laptop Computers.
All Risks would cover the equipment in the event of fire, theft and accidental damage but is on a wider basis covering the items whilst being used anywhere in the British Isles. Optional, Cover required:  Yes No

Total value of equipment £

Single Article Limit Single Article Limit
A single article limit is the maximum value of any one item to be insured within the total value of equipment declared. - £500 £1,000 £1,500 £2,000

ACTIVITIES - STANDARD EXCLUSION (PUBLIC & PRODUCTS LIABILITY)

We do not cover liability arising:
a) from any of the following activities:

• abseiling
• aerial activities of any kind
• climbing of any kind
• dry slope skiing
• fire walking
• football that is played within a league system
• gorge walking and the like
• gymnastics
• horse or pony riding of any kind
• landboarding
• professional sport of any kind
• racing or time trials other than on foot
• rugby and other contact sports
• trampolining
• underground activities of any kind
• water activities, other than:
  • swimming or snorkelling
  • the use of hand or foot propelled watercraft on inland waterways or lakes provided they are not used in any white water activity
• weightlifting
• winter sports

b) from any activity that involves the use of:

• bicycles other than for normal road use
• cables, ropes, or wires
• elastic ropes
• fireworks or explosive items
• ice skates
• motorised fairground rides
• play inflatables other than bouncy castles
• roller skates, roller blades or skateboards
• weaponry

c) from any activity that involves the ownership, possession or use by you or on your behalf, or by any person entitled to cover under this Section, of any:
i) mechanically propelled vehicle for which compulsory motor insurance or security is required, other than for loading and unloading unless cover is provided by any other policy
ii) where not excluded under i) above, motor car, van, lorry, motor unit of an articulated lorry, coach, bus, mini-bus, trailer used for carrying people or any full scale or scaled down version of the following:
- quad bike, go-kart, motorcycle, motor tricycle, motor scooter or moped unless declared by you to us and endorsed by us onto the Schedule.

Subject otherwise to the terms, exceptions and conditions of the Policy.

Important Notes

• We reserve the right to ask for special terms or decline this request for insurance.
• We will supply an electronic copy of this Statement of Fact when we issue the policy.
• You should keep a record of all information that you supply to us for the purposes of entering into a contract of insurance.
• Any policy issued as a result of this Statement of Fact will be governed by the law of England unless your legally registered address is located in Scotland in which case the law of Scotland shall apply. If there is any dispute as to which law applies it shall be English law.
• We will communicate with you in English at all times.
• By accepting this Statement of Fact you are confirming that the statements apply to you and any director, partner, trustee or committee member.
• Subject to our compliance with current data protection legislation, we may share information with other insurers, companies or agencies, including the police authorities, for the purposes of fraud prevention, credit checking, confirmation of relevant facts, debt recovery, claims adjustment or investigation and otherwise in compliance with any legal requirement.
• If you are in any doubt whether the following statements are applicable to you, or if there are other facts which might influence the acceptance or assessment of the Statement of Fact or which you think may be relevant, these should be discussed with your insurance advisor or Ansvar before accepting this Statement of Fact.
• If you:
  • fail to supply facts which should be advised to us for
  • supply inaccurate information to obtain
  • make a fraudulent claim on
• any policy issued as a result of this Statement of Fact then, dependent upon the circumstances, we may either void the policy (i.e. treat it as though it had never been issued) without premium refund, cancel the policy or refuse a claim payment.
• The following statements form part of, and are the basis for the required insurance contract.

Statements
You or any members:

• are a member of TAROE either directly or indirectly
• are based in the UK
• do not have any overseas activities, assets or employees.

You or any members have not:

• had a claim or sustained loss or incurred any liability caused by any of the risks to be insured within the last 3 years
• had any criminal convictions other than motoring offences (any convictions spent under the Rehabilitation of Offenders Act can be ignored)
• been declared bankrupt or are / is not the subject of any unsatisfied County Court Judgement
• been the subject of a prosecution or notice of intended prosecution under any health and safety at work or consumer protection legislation
• been the subject of a pending investigation, or been investigated in the last three years, by the Charity Commission, Revenue and Customs or any other regulatory body
• had any insurance, or proposal for insurance, declined or cancelled, or had any special conditions imposed or renewal refused, for any of the risks to be insured
• Your income does not exceed £50,000

Are you able to confirm that the above statements are applicable to you? Yes No

(If NO, please contact us to discuss this further, or alternatively complete and return our Quotation Form so that we are able to obtain alternative quotes for you to consider).

Your name:

Position:

Date:

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