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Small Business Insurance – Assessment of Demands and Needs
Insurance Brokers, Companies and Intermediaries
Other Insurance Brokers, Insurance Companies or Insurance Intermediaries that you have approached for quotations to date
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Have you ever had any insurance proposal declined or cancelled?
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Policy Details
Property to be Insured
Risk Addresses
Address
Actions
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Risk Addresses.
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Buildings
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Buildings Sums Insured
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Stocks
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Stocks Sums Insured
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Stocks Description
Furniture, Fixtures and Fittings
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Furniture, Fixture and Fittings Sums Insured
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Machinery and Plant
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Machinery and Plant Sums Insured
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Machinery and Plant Description
Passenger Lifts
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Passenger Lifts Sums Insured
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0
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Forklifters
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Forklifters Sums Insured
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0
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12 Month's Rent
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12 Month's Rent Amount
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Office Electronic Equipment
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Office Electronic Equipment Sums Insured
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Liabilities
Number of Employees
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0
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Estimated Annual Wageroll of Employees
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Public Liability Limit required
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€250,000
€500,000
€750,000
€1,000,000
Other Information
Jurisdiction you would like your Policy to operate in
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Maltese
European
Worldwide
Worldwide (Excl. USA & Canada)
Kindly provide details of fire safety and security provisions situated in the premises
Fire Alarm
Intruder Alarm
Fire Extinguishers
Shutters on main door / windows
CCTV
Other policies you may be interested in obtaining a quotation for
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Money
Business Interruption
Goods In Transit
Deterioration of Stock
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Details and amounts of any previous losses and/or claims
Accident Details
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Additional Details
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Client Terms of Business & Privacy Policy
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I understand that by completing this form the data will be processed by MIB in line with GDPR and hereby consent that this data (including if needed sensitive data as defined in article 9 of GDPR) are used for the purposes of providing your insurance services.
I also understand that it is my responsibility to secure and hold the necessary consent from any employees, beneficiaries or other third parties direct or indirectly involved in the insurance proposal/arrangements and whose data will be processed by MIB and the providers of insurance and ancillary services.
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