PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL FORM
Your Duty of Disclosure
Before you complete this Proposal Form and enter into a contract of general insurance, please be aware that you have a duty, under the Insurance Contracts Act 1984 (Cth.), to disclose to the Insurer every matter that you know, or could reasonably be expected to know, is relevant to the Insurera��s decision whether to accept the risk of the insurance and, if so, upon what terms.
You have the same duty to disclose those matters to the Insurer before you renew, extend, vary or reinstate a contract of general insurance and this duty continues after the Proposal Form has been completed up until the time the policy is entered into.
Your duty however does not require disclosure of matters:
- That diminishes the risk to be undertaken by the Insurer;
- That is of common knowledge;
- That your Insurer knows or, in the ordinary course of its business, ought to know; or
- Where the insurer agrees to waive compliance with your duty of disclosure.
If you fail to comply with your duty of disclosure, the Insurer may be entitled to reduce their liability under the contract in respect of a Claim or may cancel the contract. If your non-disclosure is fraudulent, the Insurer may also have the option of avoiding the contract in its entirety. It is therefore vital that you make sufficient enquiries BEFORE you complete your Proposal Form and BEFORE you sign any declaration that there has been no change in the information provided.
Management Liability Insurance is issued on a CLAIMS MADE and NOTIFIED basis. This means that these covers only respond to:
- Claims first made against you during the insurance period and notified to the Insurer during that insurance period, providing that you were not aware at any time prior to the policy inception of circumstances which would have put a reasonable person in your position on notice that a Claim may be made against you; and
- Claims notified pursuant to Section 40, sub-section 3 of the Insurance Contracts Act 1984 (Cth.), which states: a�?Where the Insured gave notice in writing to the Insurer of facts that might give rise to a Claim against the Insured as soon as was reasonably practicable after the Insured became aware of those facts but before the insurance cover provided by the contract expired, the Insurer is not relieved of liability under the contract in respect of the Claim, when made, by reason only that it was made after the expiration of the period of insurance cover provided by the contracta�?.
When the policy expires, no new notification generally can be made on the expired policy even though the event giving rise to a Claim against you may have occurred during the insurance period. You will not be entitled to indemnity under your new policy in respect of any Claim arising out of circumstances of which you were aware at any time prior to policy inception which would have put a reasonable person in your position on notice that a Claim may be made against you. When completing this Proposal Form, you are obliged to report and provide full details of all circumstances which have become known to you and which would put a reasonable person in your position on notice that a Claim may be made against you. This is important to ensure that you make proper disclosure (refer to notice pursuant to the Insurance Contracts Act 1984 (Cth.) in order that your entitlement to full indemnity under your new policy is not placed in jeopardy. In accordance with the provisions of the Insurance Contracts Act 1984 (Cth.), DUAL Australia is required to advise you of your responsibilities in relation to the disclosure of relevant information.
Surrender or Waiver of any Right of Contribution or Indemnity
Where another person or company would be liable to compensate you or hold you harmless for part or all of any loss or damage otherwise covered by the policy, but you have agreed with that person either before or after the inception of the policy that you would not seek to recover any loss or damage from that person, you are NOT covered under the policy for any such loss or damage.
Contract by the Insured Affecting Rights of Subrogation
If the proposed contract of insurance includes a provision which excludes or limits the Insurera��s liability in respect of any loss because you are a party to an agreement which excludes or limits your rights to recover damages from a third party in respect of that loss, you are hereby notified that signing any such agreement may place your indemnity under the proposed contract of insurance at risk.
When Completing this Proposal Form
- Please answer all questions honestly, giving full and complete answers.
- It is the duty of the Applicant to provide all information that is requested in the proposal form as well as to add any additional relevant facts.
- A relevant fact is a fact and/or circumstance that may influence the evaluation of the risk by the insurer. If you have any doubts about what a relevant fact is, please do not hesitate to contact your broker.
- If the space provided on the Proposal Form is insufficient, please use a separate signed and dated sheet in order to provide a complete answer to the question.
- The Proposal Form must be completed, signed and dated by a person, who must be of legal capacity and authorised for the purpose of requesting management liability insurance for the firm who acts as a Applicant.