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Cancellation and Abandonment Insurance

  1. **PLEASE CLICK HERE TO READ IMPORTANT INFORMATION ON THE CANCELLATION & ABANDONMENT INSURANCE QUESTIONNAIRE

    (Note: this will open up a new tab in your browser)

  2. 1. GENERAL INSURANCE INFORMATION REQUIRED

  3. Client Name(*)
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  4. Postal Address(*)
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  5. Suburb(*)
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  6. State(*)
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  7. Postcode(*)
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  8. Contact Person(*)
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  9. Phone Number(*)
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  10. Fax Number
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  11. Email Address(*)
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  1. Business activities of the Proposer (please describe your activities in as much details as possible)(*)
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  2. Period that cover is required for(*)
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  3. Period Date From:
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  4. Period Date To:
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  5. If you require cover for all events during annual period, please provide a schedule of events, dates and locations to be insured

  6. Event
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  7. Date
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  8. Location
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  9. Event
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  10. Date
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  11. Location
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  12. Event
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  13. Date
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  14. Location
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  15. Event
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  16. Date
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  17. Location
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  18. If insufficient space, please provide a separate schedule
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  19. If you only require cover for a ‘one-off’ event, please provide location of where the event will take place?
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  20. Is the event/s being held outdoors?
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  1. 2. IF 'YES'(EVENT/S BEING HELD OUTDOORS) AND COVER IS REQUIRED FOR CANCELLATION DUE TO ADVERSE WEATHER, PLEASE COMPLETE THE FOLLOWING QUESTIONS.

    Note: The Policy will only cover cancellation of your event if the weather conditions fall within the definition of ADVERSE WEATHER as defined by the policy wording (please contact us if you would like a copy of this definition prior to completing this form).

    This policy is NOT a Pluvius Policy. Rainfall alone may not be sufficient to trigger a claim under the policy UNLESS such rainfalls within the definition of ADVERSE WEATHER.
  2. Please specify what type of weather conditions would affect your event/s:
  3. Heavy Rain
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  4. Light Rain
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  5. Lightning
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  6. High Winds
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  7. Are all performers and equipment under cover?
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  8. If 'YES' , please describe the construction of stage and coverage:
  9. Walls
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  10. Floors
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  11. Roof
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  12. Note: Policy will be subject to a Stage Covered Warranty and Electrics Protection Warranty. All performers and equipment must be covered by 3 side walls and a roof and all electrics protected against weather and water damage.
  13. Is the event location close to a water course?
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  14. If the venue is close to a water course, please answer the following questions:

    Please State:
  15. The Nature of the venue site eg. Sand/Chalk/Clay etc.
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  16. Whether there have been any substantial changes to the venue. eg Development(s), Drainage works etc.
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  17. if so, the date of the works.
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  18. Whether there have been any substantial nearby developments eg. New Buildings, New roads, Drainage works etc,
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  19. if so, the date of the works.
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  20. Is/are the venue(s) lowlying
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  21. Is/are the venue(s) liable to flooding
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  22. Is/are the venue(s) near any water courses/river/lake
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  23. Is/are the venue(s) ever been flooded
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  24. Is/are the venue(s) significantly exposed to wind or rain
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  25. If any question above for venue is yes, pleae give full details by attaching documents
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  26. Has the venue land any underground natural reservoir or aquifer?
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  27. If yes please state the water level therein
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  28. Are there any hard standing access roads within the site
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  29. Is/are the entrance(s) and exit(s) hard standing
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  30. What are the car park arrangements for the event(s)
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  31. are there seperate entrances and exits for event setup traffic and visitor traffic
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  32. Does the financial success of the event rely on ticket sales?
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  33. Please note that a CANCELLATION/ABANDONMENT policy DOES NOT cover financial losses resulting form inadequate ticket sales or shortfall in attendance.

  34. Does the financial success of the event rely on ticket sales?
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  35. Please advise estimate number of tickets sales
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  36. How many tickets will be sold prior to the day of the event
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  37. How many tickets will be sold on the day of the event?
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  38. Estimated ticket price
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  39. Do you believe that rain could affect the expected attendance?
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  40. If yes, do you require cover for a financial loss resulting from a shortfall in attendance caused by rain?
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  41. If 'YES' then we would recommend that you consider taking out a PLUVIUS INSURANCE policy in addition to the CANCELLATION/ABANDONMENT policy. A PLUVIUS insurance policy will cover financial losses resulting from a certain limit of rain falling within an agreed time period.
  42. Would you like a separate quotation on PLUVIUS INSURANCE?
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  1. 3. PLEASE COMPLETE THIS SECTION IF COVER IS REQUIRED FOR CANCELLATION OF THE EVENT DUE TO THE NON-APPEARANCE OF THE ARTIST / PERFORMER

  2. Name of artist or performer
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  3. Names and ages of members whose non-appearance would cause cancellation:
  4. First & Last Name (1)
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  5. Date of Birth (1)
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  6. First & Last Name (2)
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  7. Date of Birth (2)
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  8. First & Last Name (3)
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  9. Date of Birth (3)
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  10. First & Last Name (4)
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  11. Date of Birth (4)
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  12. If insufficient space, please provide a separate schedule
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  13. Date of Arrival
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  14. Have you made any allowances for travel delay?
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  15. If yes, please advise
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  16. Is the performer / artist currently in good health?
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  17. If no, please advise
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  18. Note – a medical certificate is required proving the artist / performer is in good health and fit to perform.
  19. Does the artist / performers have any pre-existing medical conditions?
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  20. If yes, please advise?
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  21. Are you aware of any previous cancellations or non-appearance by this artist / performer?
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  22. If yes, please provide details of previous cancellations
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  23. Have all the necessary documents, passports and visas been obtained to allow this artist / performer in to Australia?
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  24. If no, please advise when such documents will be obtained?
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  25. Do you require an extension to cover non-appearance of the artist(s) or performer(s) as a result of death, accident or illness of any of the artists(s) or performers(s) family members?
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  26. Note: This extension may incur additional premium and cover only applies on the death, accident or illness of family members (as defined in the policy) under the age of 70 years.
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  1. 4. SUM INSURED (Note: Must represent the total value at risk – underinsurance condition applies to this insurance)

  2. Expected gross revenue from ticket sales, food & beverages, merchandise, sponsorship and/or guarantees or other sources? $(*)
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  3. Please specify your total costs / expenses for staging this event/s? $ (please provide a schedule of costs/expenses)(*)
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  4. Do you wish to insure against:(*)
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  5. Note: Should you choose to insure for costs/expenses only, you will not be insured for loss of net profit.
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  1. 5. OTHER GENERAL INFORMATION REQUIRED

  2. Have you or any other party to this insurance, suffered a loss or insurance claim under a policy this type?
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  3. If yes, please advise details?
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  4. Have you or any other party to the insurance, ever been refused insurance or had a policy declined by an Insurer, or had the Insurer impose special terms, conditions or excesses on a policy of this type?
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  5. If yes, please provide details?
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  6. Have all the necessary documents, approvals and permission been obtained to stage this event/s?
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  7. Are you aware of any factor that may cause a claim under this insurance?
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  8. If yes, please provide details?
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  1. 6. OTHER INSURANCES We recommend the following other insurances and ask that you contact our office if you would like further information on any of these including quotations:-

  2. PUBLIC LIABILITY INSURANCE FOR SPECIAL EVENTS, CONCERTS ETC.
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  3. VOLUNTARY WORKERS ACCIDENT INSURANCE
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  4. WORKERS COMPENSATION (COMPULSORY FOR ALL EMPLOYERS)
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  5. MONEY
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  6. BUSINESS EQUIPMENT (INCLUDING HIRED OR BORROWED ITEMS)
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  7. PROFESSIONAL INDEMNITY FOR EVENT ORGANISERS
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  8. PLUVIUS INSURANCE
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  9. Additional Info
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  10. DECLARATION : I/We hereby declare that the information provided by me/we in this questionnaire is true and correct and that I/we have read and understand the Important Notices at the start of this questionnaire. I/We also agree that this questionnaire can be used as the proposal of insurance and therefore the basis of the contract of insurance between me/we and the underwriter, if so approved by the underwriter. In submitting this form, I acknowledge that I may receive documentation from Action Insurance Brokers P/L by email. I further agree that Action Insurance Brokers P/L may from time to time send me important information about new insurance products and services.
  11. I/We agree:
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  12. Anti-Spam
    Anti-Spam
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  13. Submit