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Insurance Proposal Form

Insurance Proposal Form Template for New Zealand

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Key Requirements PROMPT example:

Insurance Proposal Form

"I need an Insurance Proposal Form for a medium-sized manufacturing company in Auckland, with specific focus on machinery breakdown and business interruption coverage, including cyber risk elements and international shipping exposure."

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Document background
The Insurance Proposal Form is a fundamental document in New Zealand's insurance industry, serving as the primary means of gathering information for risk assessment and policy issuance. This document is used when an individual or organization seeks new insurance coverage or wishes to renew existing policies. The form must comply with New Zealand's legal framework, including the Insurance Law Reform Act 1977, Privacy Act 2020, and Fair Trading Act 1986. It captures crucial information about the proposed risk, including business operations, risk management practices, claims history, and other material facts that could influence the insurer's decision to provide coverage and determine appropriate terms and conditions.
Suggested Sections

1. Proposer Details: Basic information about the applicant including full legal name, trading names, contact details, and business structure

2. Privacy Statement: Mandatory statement explaining how personal information will be collected, used, and protected in accordance with the Privacy Act 2020

3. Risk Details: Core information about the risk to be insured, including location, nature of risk, and basic operational details

4. Claims History: Disclosure of previous claims, incidents, or circumstances that could give rise to claims

5. Risk Management: Information about existing safety measures, security systems, and risk mitigation procedures

6. Insurance History: Details of current and previous insurance arrangements, including any declined coverage or special conditions

7. Material Facts: Section for disclosure of any other material facts that could influence the insurer's decision

8. Declaration: Formal statement confirming the truth and completeness of information provided, including duty of disclosure acknowledgment

Optional Sections

1. Business Activities: Detailed section for commercial insurance proposals, including business operations, turnover, and employee details

2. Property Details: Specific section for property insurance, including construction details, occupancy, and protection measures

3. Professional Services: For professional indemnity insurance, detailing services offered, qualifications, and risk management procedures

4. Vehicle Schedule: For motor fleet insurance, including details of all vehicles to be insured

5. Directors and Officers: For D&O insurance, including details of company structure, directors, and corporate governance

6. International Operations: For businesses operating internationally, detailing overseas exposures and operations

7. Cyber Security: For cyber insurance, detailing IT systems, security measures, and data handling procedures

Suggested Schedules

1. Asset Schedule: Detailed listing of assets to be insured, including values and specifications

2. Claims Experience Appendix: Detailed breakdown of claims history for the past 3-5 years

3. Risk Survey Reports: Any pre-existing risk survey reports or assessments

4. Financial Statements: Recent financial statements where relevant to the risk assessment

5. Site Plans: Property layouts and site plans for property insurance

6. Security Certificates: Copies of relevant security, safety, or compliance certificates

7. Supplementary Questionnaires: Additional specific questionnaires for particular types of coverage or risks

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Relevant Industries

Financial Services

Manufacturing

Retail

Professional Services

Construction

Healthcare

Technology

Agriculture

Transportation

Education

Hospitality

Real Estate

Mining

Energy

Non-Profit Organizations

Maritime

Relevant Teams

Legal

Risk Management

Finance

Compliance

Operations

Facilities Management

Health and Safety

Procurement

Administration

Property Management

Fleet Management

Relevant Roles

Risk Manager

Insurance Manager

Chief Financial Officer

Compliance Officer

Legal Counsel

Operations Manager

Facility Manager

Health and Safety Manager

Company Secretary

Chief Executive Officer

Financial Controller

Business Owner

Property Manager

Fleet Manager

Office Manager

Procurement Manager

Industries
Insurance Law Reform Act 1977: Governs fundamental aspects of insurance contracts including provisions for disclosure, warranties, and time limits for claims. Critical for ensuring the proposal form meets statutory requirements for information collection.
Fair Trading Act 1986: Ensures that the proposal form doesn't contain misleading or deceptive content and that all information is presented fairly and clearly to the potential insured.
Privacy Act 2020: Regulates how personal information is collected, used, and stored. Essential for ensuring proper privacy statements and consent mechanisms are included in the proposal form.
Contract and Commercial Law Act 2017: Provides the general framework for contract formation and enforcement, affecting how the proposal form is structured as a pre-contractual document.
Financial Markets Conduct Act 2013: Regulates financial products and services, including insurance products, and sets requirements for disclosure and fair dealing.
Insurance Intermediaries Act 1994: Relevant if the proposal form will be used by insurance brokers or intermediaries, governing their duties and obligations.
Human Rights Act 1993: Ensures the proposal form doesn't contain discriminatory questions or practices in collecting information from potential insureds.
Insurance (Prudential Supervision) Act 2010: While primarily focused on insurer supervision, it contains provisions that may affect how certain information is collected and disclosed in proposal forms.
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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