Saturday, 19 May 2012
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Photographers Liability Insurance Questionnaire
  1. Please click here to read important information on the Photographers Insurance Questionnaire
  2. Client / Company name(*)
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  3. A.B.N. (if applicable)
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  4. Contact Person(*)
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  5. Postal address(*)
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  6. Suburb(*)
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  7. State(*)
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  8. Post Code
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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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  12.  
  1. Business activities to be insured (Style of Photography e.g. Wedding, portraiture, sports etc)(*)
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  2. How many years experience do you have in this field and/or how long has your business been operating for?
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  3. Period that cover is required for:

  4. Annual period From:
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  5. Annual period To:
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  6. Limit of cover required:(*)
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  7. Business Address you operate from (please provide address or location of where you will be predominantly carrying out your business activities):
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  8. Do you carry out any activities outside of Australia?
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  9. If yes, please provide countries
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  10. Please advise the estimated turnover / wages of your business for the next 12 month period?

  11. Turnover $ (Gross Income)(*)
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  12. Wages $
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  13. Number of employees
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  14. Do you use contractors / sub-contractors?
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  15. What activities will your contractors carry out?
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  16. Estimated payments to contractors / sub-contractors $
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  17.  
  1. Will you be signing any contracts that contain hold harmless or indemnity agreements?
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  2. If yes, please provide copies of such agreements.
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  3. Note – a hold harmless or indemnity agreement is whereby one party assumes the liability risks of another party under contract. Your public liability policy is to cover your legal liability & no one else’s, therefore claims arising from these agreements are excluded. In some circumstances, your policy can be amended to include cover for these agreements providing your Insurer can review them & agree to their content. If you sign these agreements without first referring them to your Insurer, you may not be covered in the event of a claim.

  4. Will you require cover for liability claims arising from loss or damage to other people’s property whilst in your care, custody or control?
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  5. If yes, please advise limit of cover? $
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  6. Note – the above extension only operates if you are negligent in causing the loss or damage to the property in your care, custody or control. There can be situations where you have hired or borrowed other people’s property, & such property is lost or damage not as a result of your negligence. However, you may still be responsible for compensating the owner for their loss. In these circumstances, it would be prudent not to rely on the above extension on it’s own but also insure the hired or borrowed property under a General property insurance policy, which will operate regardless of fault or negligence.

  7. Have you suffered any public liability claims or have caused incidents that could give rise to a public liability claim?
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  8. If yes, please provide details
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  9. Have you had any criminal convictions, been bankrupt or refused insurance
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  10. If yes, please provide details
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  11. Have you previously been insured for public/products liability?
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  12. If yes, please advise name of Insurer
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  13. Will your activities involve any dangerous, hazardous, extreme sporting activities, stunts, fire or fireworks?
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  14. If yes, please provide details
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  15. Will your activities include the use of any of the following:

  16. Registered motor vehicles
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  17. Watercraft
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  18. Aircraft or hovercraft
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  19. Do you do any film or video production activities?
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  20. If yes, please provide details:
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  21. Where did you here about Action Entertainment Insurance?
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  22.  

  1. 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. CANCELLATION INSURANCE (INCLUDING WEATHER & NON-APPEARANCE)
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  3. WORKERS COMPENSATION (COMPULSORY FOR ALL EMPLOYERS
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  4. BUSINESS EQUIPMENT (INCLUDING HIRED OR BORROWED ITEMS)
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  5. Additional Info
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  6. 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 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.

  7. I/We agree:(*)
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  8. Anti-Spam
    Anti-Spam
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  9. Submit