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Assumptions

1. Have any claims been made against you under this or any similar insurance? *

Yes

2. Have you been subject to any disciplinary hearings or are there any pending? *

Yes

3. Are you aware of any incidents that have occurred which may have given rise, or may give rise in the future, to a claim under the policy? *

Yes

4. Have you ever had any suits for negligence, error or omission made against you which would have been the subject of a claim under the insurance being proposed? *

Yes

5. Under current or any previous trading titles, have you ever been convicted of any criminal offence, other than motoring, or have any prosecution pending? *

Yes

6. In respect of the therapies for which you are requesting cover, do you hold, or are you studying for, at least the minimum qualifications required to carry out the treatments/therapy *

Yes

7. In respect of any therapies for which you may apply for student cover, do you understand that you will not offer treatments outside of your capabilities, and at all times shall be governed by the phase reached in your training programme and your tutor’s/supervisor’s assessment? *

Yes

8. Do you understand that in the event of a claim being reported, proof of your qualifications will be required prior to indemnity being confirmed and that, if you have declared that you are a member of an Approved Association or College, proof of your membership will also be required? *

Yes

9. Has any Insurer ever cancelled, declined, refused to renew or only accept on special terms, your liability insurance? *

Yes

10. While you may practice online with clients who are located anywhere in the world, do you accept that you may not practice for more than 90 days in any policy period from outside of Ireland, the United Kingdom, Isle of Man or the Channel Islands, and you may not undertake any work if you are located in the USA or Canada? *

Yes

11. Do you understand that this policy will only cover your interest as a Sole Trader/Therapeutic Practitioner and does not extend to liabilities that may be incurred operating a Limited company? *

Yes

Proposer Details

Title *

What is your Name *

Address line 1 *

Address line 2

City/Town *

County *

Eircode

Telephone number *

Email address *

Would you like documents sent by POST *

Yes

Date Of Birth *

The date should be between 17-09-1925 and 17-09-2007

You have read and agree to our Terms of Business *

You have read and agree to the Data Protection Policy *

You have agreed to the Honesty Declaration *

Cover Details

Please select the level of cover you would like to buy insurance for *

Qualified Practitioner

Student

Qualified and Student Practitioner

Policy Details

Insurance start date *

The date should be between 17-09-2025 and 17-10-2025

Will you be working with clients under 16 years of age? *

Yes

Are you a member of an approved college or association? *

Yes

Do you require a specific premises or organisation to be noted on your policy? *

Yes

Please select which of these therapies, if any, you are qualified/practicing supervisor of and require supervision cover for

Please check your inputs. Additional information is required.