IMPORTANT NOTICE

Please read the following carefully before you sign and date the Declaration below.

  • The questions on this proposal form and any other details we specifically request relate to facts which we
    consider material to underwriting this insurance. However, because no list of questions can be exhaustive please
    consider whether there is any other material information which is known to you which could influence our
    assessment and acceptance of the risk. FAILURE TO DISCLOSE ALL MATERIAL FACTS WHETHER OR NOT THE SUBJECT OF A
    SPECIFIC QUESTION MAY INVALIDATE YOUR INSURANCE.
  • We recommend that you should keep a record, including copies of letters and this Proposal Form, of all
    information supplied to us for the purpose of entering into this insurance.

  • All personal information supplied by you will be treated in confidence and will not be disclosed to any third
    parties except where your consent has been received or where permitted by law. In order to provide you with
    products and services this information will be held in our data systems.
    Underwriters may pass your personal data to other companies for processing on its behalf. Some of
    these companies may be based outside Europe in countries which may not have laws to protect your
    personal data, but in all cases they will ensure that it is kept securely and only used for the
    purposes for which you provided it. Details of the companies and countries involved can be provided to
    you on request.

DECLARATION

Before signing the Declaration please check your answers carefully particularly if this Proposal Form is not
completed in your own hand.

  • I/We declare that to the best of my/our knowledge and belief the answers given are true and complete.
  • I/We agree that if any answers have been completed by any other person, such person shall for that purposes be
    regarded as my/our agent and acting on my/our behalf, and not the agent of Underwriters.
  • I/We declare that this Proposal Form is for insurance in the normal terms and conditions of the Insurer’s
    policy.
  • I/We agree that the information provided on this Proposal Form and any information supplied by me/us shall be
    incorporated in and form part of the insurance contract.