Tour Operator Combined
Insurance
Proposal Form
Prepared by Campbell Irvine (Insurance Brokers) Limited
Tour Operator Division
52 Earls Court Road, Kensington, London, W8 6EJ
Telephone 020 7937 6981
Fax 020 7938 2250
[Link]
Authorised & Regulated by the Financial Services Authority
Professional Risk Solutions for the Tour & Travel Industry
Tour Operator Combined Insurance
(A) Company Details
Full Title of proposer, including any subsidiary companies
Addresses of all offices
Business Description
Telephone No HMRC Employer Ref no
Year Established Country of Registration
(B) Employers Liability (Optional)
Wage-roll for all staff undertaking clerical work in the UK £
Wage-roll for all staff undertaking work abroad or manual work*
£
*Please specify duties
(C) Public Liability & Professional Indemnity
Inclusive Tours estimated annual turnover for next 12 months £
Flight/Accommodation only estimated annual turnover for next 12 months £
Travel Agency Turnover, estimated for the next 12 months £
£
Activity Days/Corporate Events estimated turnover for the next 12 months
Passenger Numbers Estimated for the next twelve months
Tour Operator Combined Insurance
(D) Liability Operation Breakdown
Please give an approximate % of turnover breakdown, between the following categories:
Overland / Safari Tours Trekking
(without use of crampons)
Adventure / Activity Holidays Trekking
(with crampons and the like)
Children / Student Tours City Breaks / Villa Holidays
Activity Days / Corporate Events Other Package Holidays
Please give an approximate % breakdown of geographical areas you expect to send clients to:
UK Europe
North America Africa
Elsewhere in the World Areas against FCO advice
(E) Liability / PI Claims
No. of claims or incidents reported to Insurers in the past five years for passenger injury
Value of claims paid and outstanding estimates for passenger injury over past five years £
No. of claims made to Insurers for complaints not involving injury
Value of non-injury claims paid and outstanding for past five years £
No. of claims made over past five years for injury to employees
Value of claims paid for injury or illness to employees over past five years £
(F) Tour Leaders or Guides ONLY (Optional)
How many years experience do you have as a tour leader or guide?
Please provide details of the tours/trips which you will be running or leading:
Tour Operator Combined Insurance
Number of claims in the past 5 years (Please provide details on a separate sheet)
Please ensure that you provide an up to date CV
with this application and that you have also
completed sections A, D F, G & J of this form
(G) General Liability Information
Yes No
Do you or your agents inspect accommodation regularly to ensure
that local standards of health and safety are met?
Do you ensure that your suppliers have adequate liability insurance
in place?
Do you own or operate any accommodation or transport?
Do you ensure that all activity suppliers operate to at least local safety
standards and that all safety equipment is to a suitably high standard
and subject to regular safety checks?
Do you check to ensure that all vehicles provided by suppliers are
roadworthy and comply with local legal requirements? Where possible
do you ensure that safety belts are fitted?
Do you ensure that clients are aware that optional excursions outside of
the pre-booked and paid for itinerary are undertaken at their own risk?
Have you put in place a risk management and assessment programme
for your tours and suppliers?
If any of your tours include the following activities, please provide a %
estimate of how much this relates to your overall turnover:
Mountain Biking Horse/Camel Riding Mountaineering
(H) Current Liability Insurance Details
Insurer
Renewal Date / Premium £
(I) Liability Quotes Required
Public Liability
£2,500,000 £5,000,000 £10,000,000
Professional Indemnity
£250,000 £500,000 £1,000,000
Tour Operator Combined Insurance
Employers Liability (Optional)
Is cover required (£10,000,000 limit of indemnity)?
(J) Material Damage Cover (Optional)
ITEMS TO BE INSURED Sum Insured
Buildings, walls, gates & fences £
Tenants improvements and interior decorations £
Stock in trade £
General office contents & furniture £
Computers & telephones in the office £
Computer systems records £10,000
Theft of any one ticket £2,500
Fidelity Guarantee £10,000
Loss of Gross Revenue (Indemnity Period) £ ( months)
Increased cost of working (Indemnity Period) £ ( months)
Loss of rent (Indemnity Period) £ ( months)
Book debts £10,000
Money in transit &/or in bank night safe
£2,500
Money on premises during business hours
Money on premises out of business hours in locked safe £2,500
Money on premises out of business hours, not in locked safe £250
Business money at the home of an employee £500
Personal accident, following assault, resulting in:
Death £10,000
Permanent total disablement (other than loss of sight or limbs) £10,000
Loss of sight or loss of limbs £10,000
Temporary total disablement £100 per week
Tour Operator Combined Insurance
Portable items anywhere in the United Kingdom
£ £
£ £
Portable items anywhere in Europe
£ £
£ £
Portable items anywhere in the World
£ £
£ £
Addresses of all premises requiring cover:
Intruder Alarm method of signalling
Is the installer NACOSS-approved?
Is the system subject to an annual maintenance contract?
Are the premises occupied overnight?
Are key-operated window locks fitted to all accessible, opening windows?
Are all external doors fitted with locks to BS3621 or equivalent?
Please describe the construction materials of the following:
Walls Roof
Floor Stairs
If the roof is flat, please provide details of the percentage of total roof area, condition and age
Are the premises in a good state of repair?
Have the premises ever suffered from subsidence/heave or landslip?
Do the premises have a listed status?
Have you made any material damage claims in the past 5 years?
Has any Insurer refused to accept a proposal from you?
Tour Operator Combined Insurance
Has any Insurer refused to continue a contract of Insurance held by you?
Has any insurer imposed special terms upon you?
Has any Director ever been convicted of or is any prosecution pending
for any offence involving arson, criminal deception, fraud, forgery, theft,
robbery, handling stolen goods, any crime or violence or with any
other offence against property?
Has any Director been declared bankrupt or been a director of any
company that went into liquidation?
Are there any County Court Judgments or arrangements with creditors
outstanding?
(K) Declaration
Please ensure that where appropriate, the following information is submitted with your proposal form, to
allow swift and accurate assessment:
Brochure Full details of hazardous activities
Web-site address Full details of all claims
CV’s for all directors if this is a new venture
Details of any assets in North America if Worldwide Legal Jurisdiction is required
Completion of this proposal form is designed to provide Underwriters with a
platform to consider the risk. It does not bind or oblige Underwriters to
provide cover. Cover can only be granted following written confirmation
from you that you wish to proceed in accordance with a written quotation
submitted by us.
I/We hereby declare that the information provided within this proposal is
accurate and true, to the best of my/our knowledge at the time of signing.
I/We further understand that failure to declare or mis-representation of
any material fact could lead to my/our position being prejudiced in the
event of a claim. I/We understand that a material fact is one which is likely
to influence the underwriter’s perception or assessment of the risk. I/We
understand that in the event of non-disclosure or mis-representation, by us,
Underwriters reserve the right to withdraw cover in whole or in part.
Tour Operator Combined Insurance
Signed Print Name & Position
Dated