Information and Quotes Management Liability

Complete the questionnaire below and submit it to us and we'll contact you to arrange a quotation.

First Name:
Surname:
Business Name:
ABN:
What industry are you involved in?
What is your approximate annual turnover?
How many people including directors are involved in the business?
Have you ever had a claim for Management Liability related covers?	Yes No
Do you you have representation outside Australian Territories?	Yes No
Do you currently have Management Liability or Directors & Officers?	Yes No
Have you ever had Management Liability or Directors & Officers?	Yes No
Do you require executive director accident cover ?	Yes No
Address:
Postcode:
Telephone:
Fax:
Email:

Eligibility for Management Liability Insurance


Are you a Pty Limited Company?	Yes No