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Management Liability Insurance QUOTATION Request

Please complete this form to request a Management Liability Quotation.

This form will collect key details about your business, financials, and cover requirements so we can provide an accurate quotation tailored to your needs.

💡 Tip: If you’re unsure about any question, just answer as best you can — we’ll follow up if more info is needed.

Legal Entity Name

ABN/ACN

Contact Name

Email

Contact Number

Business Address

Describe your business activity

Date Business Established

Gross Annual Turnover ($)

Sum Insured Options

Entity Type

Number of Employees

Disclosure

In the past 5 years, have there been any claims against the company, directors, or employees?

Has any director/officer had civil or criminal proceedings instigated against them?

Has the company suffered financial loss from fraud or dishonesty in the past 5 years?

Are directors or employees aware of any facts that might give rise to a claim?

Are directors or employees aware of any facts that might cause financial loss from fraud/dishonesty?

NO to all the above