On-line Tree Loppers Public and Products Liability Insurance


Thank you for considering our on-line tree loppers public and products liability insurance service.   Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right tree loppers public and products liability insurance for you.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deals that fit your requirements.


Limit of Liability Required:
1a. Please select the amount of Liability cover required:
$5,000,000 $10,000,000 $15,000,000 $20,000,000
1b.
Public Liability (any one occurrence)
Products Liability (each Period of Insurance)
2. Do you currently have Public Liability insurance?
Yes No
If Yes, please provide details below:
Expiry Date
Insurance Company
Indemnity limit $
Excess $
Premium $
Business Details:
3. Full Description of Occupation:
4. What major items of equipment are employed by the Insured, including any high rise equipment?
5. What is the maximum height, in metres, worked to by the Insured?
6. Area of Operation:
7. Number of years in this business under this name:
8. Previous industry experience if less than five years in business:
9. Details of all claims or incidents in the past 5 years (incl. Contributing deductibles):
10. Existing deductible: $
11. Estimated annual Turnover, split by work type if applicable?
12. Estimated annual wages: $
13. Are Labour Hire Employees engaged by the Insured under a Contract of Service?
Yes No
If Yes, please advise estimated turnover and wages relating to these contracts and the activities performed by such persons:
14. Are Contractors or Sub Contractors engaged by the Insured?
Yes No
If Yes, please advise estimated turnover and wages relating to the contracts and the activities performed by such persons:
15. What work is performed away from your premises by you or on your behalf? Please provide details of such work, incl. type of sites worked on, and an estimated % of the turnover derived.
16. Do you agree to indemnify or hold harmless any other parties, by written agreement or otherwise?
Yes No
17. Limit of Indemnity: $
18. Does the Insured operate to relevant Australian Standards for the industry involved?
Yes No
If Not, what risk management procedures are in place?
19. What percentage of work performed is:
Commercial, non CBD: %
CBD Based: %
Domestic, non CBD: %
Other (please detail): %
20. What percentage of work performed is:
Domestic: %
Commercial: %
CBD Based: %
21. Does the Insured fell the trees at ground level, or are they felled progressively from the top?
Ground Level From The Top
22. Are any specific Power Line clearing contracts undertaken?
Yes No
If Yes, please advise the % of turnover derived from these contracts as well as the main Principals involved and the geographical location of such work:
23. Are safety barriers used at work sites where such are required by local, state or federal legislation?
Yes No


Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address:
Country: