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Protector/Association Liability Insurance

Application Form

To receive an indicative quote and the best service for Aon’s Protector/Association Liability insurance, please complete the details below. A member our specialist team will then get back in touch within business hours. 

  • I/We confirm that I/We have authority to complete and submit this document for and on behalf of each entity to be covered by this policy
  • I/We acknowledge that I/We have read the Notice to the proposed insured included with this form, and I/We understand those notices. I/We acknowledge that if the proposal is accepted, the insurance cover will be subject to the terms and conditions as set out in the policy wording.
  • I/We declare that the information contained in this proposal form is true and correct and that I/We have not suppressed nor mis-stated any facts.
  • I/We consent to: the use of personal information about me for the purposes shown in the privacy statement, and the disclosure of personal information about me to, and obtaining personal information from other parties, including those shown in the privacy statement, for any of these purposes.
  • If I/We have disclosed personal information about any other person, I/We confirm that I/We am authorised to: disclose to you personal information about that person and consent to its use for the purposes shown in the privacy statement, and consent to disclosure to, and obtaining of other personal information about that person from other parties including those shown in the privacy statement for any of these purposes.

Contact Details
 
Title



First Name
Surname
Organisation Name
Phone Number (please include area code eg. 02 8888 8888)
Mobile Number
Email Address

 
The Turnover of your association/organisation
Location (State) of your association/organisation
Desired Sum Insured for your association/organisation




If Other, please specify
Aon's commitment to privacy
 

 

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