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Online Premium Indication Form

To obtain a no obligation premium indication, please complete the following information.

It is our policy to validate your LI membership prior to indication of premium being provided.

Premium indication form

  • Date Format: DD slash MM slash YYYY
  • Actual gross fee income for the LAST complete financial year or estimate for new start up.
  • For sub-consultants who maintain a professional indemnity policy. If 'nil', enter '0'.
  • If 'nil', enter '0'
  • If 'nil', enter '0'
    Please tick all that apply.
  • If you answered 'yes' to current insurance arrangements, it is important you provide the following information:
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY