Quotation Form

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Gallagher is the trading name of Arthur J. Gallagher Insurance Brokers Limited. We are the data controller of any personal information you provide to us or personal information that has been provided to us by a third party. We collect and process information about you in order to arrange insurance policies and to process claims. Your information is also used for business purposes such as fraud prevention and detection and financial management. This may involve sharing your information with third parties such as insurers, reinsurers, other brokers, claims handlers, loss adjusters, credit reference agencies, service providers, professional advisors, our regulators, police and government agencies or fraud prevention agencies.

We may record telephone calls to help us monitor and improve the service we provide. For further information on how your information is used and your rights in relation to your information please see our privacy policy. If you are providing personal data of another individual to us, you must tell them you are providing their information to us and show them a copy of this notice.

Your Details
Business Name: Contact Name:
Street: Town:
County: Postcode:
Telephone: Fax:
Email: Associate Code:  
What were your total fees received for the last completed financial year? £
Do you currently hold Professional Indemnity Insurance?   Yes No
If Yes, please confirm when you first incepted this cover.

If a customer is unhappy with the work you have done and brings an action against you for professional negligence or simply decides not to pay your bill for this reason, then Hiscox Professional Indemnity policy will protect you. Please select your Professional Indemnity from the options below:

Professional Indemnity Cover
Limit of Indemnity Up to £75,000 PA £75,000 to £150,000 £150,000 - £300,000
£1,000,000 £210.00 £260.00 £425.00
£2,000,000 £300.00 £350.00 £505.00
£5,000,000 £500.00 £600.00 £1000.00

With Professional Indemnity cover: