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| Number of offices from which you engage in General Insurance. |
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| Number of employees selling or advising on General products or services. |
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| Do you currently sell pre-paid legal expenses insurance for personal customers? |
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| Do you currently sell pre-paid legal expenses insurance for commercial customers? |
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| Do you currently sell After the Event legal expenses insurance for personal customers? |
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| Do you currently sell After the Event legal expenses insurance for commercial customers? |
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| Please state the other classes of insurance you transact. |
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| Number of years you have been transacting General Insurance |
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Please advise the number of agencies you have for selling legal expenses insurance.
(excluding CLE) |
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| Please advise the number of agencies you have for selling other classes of insurance. |
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| Do you sell legal expenses insurance through sub agents? |
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| Do you sell other classes of insurance through sub agents? |
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| Have you been, or are you aware of any circumstances which may result in you being, subject to investigation or disiplinary action by a regulatory, trade or professional body? |
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| Have you been, or are aware of any circumstances which may result in you being, refused membership of any professional, trade or regulatory body or had your membership of such a body revoked or suspended? |
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| Have you been, or are you aware of any circumstances which may result in you being, the subject of a bankruptcy petition, an insolvency petition, an application to dissolve, the appointment of a receiver, administrator or trustee or entered into a composition or arrangement with creditors? |
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| Have you been, or are you aware of any circumstances which may result in you being, convicted of an offence other than a driving offence and which is not deemed a spent conviction under the terms of the Rehabilitation Of Offenders Act 1974? |
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| If you have answered Yes to any of the four questions directly above you will be asked to provide full details. |
| Are you registered under the Data Protection Ac? |
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| Do you have Professional Indemnity Insurance to cover your General Insurance activities? |
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| If yes, please advise |
Limit |
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Excess |
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