Your details
Insurance Cover
Payment

Acceptance Criteria
  • You the insured or any director, partner or principle are currently a resident of the Republic of Ireland.
  • I agree to maintain client’s records and retain them for at least 5 years. If I have not done this in the past or am just starting in business, I agree to do this now.
  • I have never had any claims made against me.
  • I have not been subject to nor have any pending disciplinary hearings against me.
  • I am not 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.
  • I have never had suits for negligence, error or omission made against me.
  • Under current or any previous trading titles, I have never been convicted of any criminal offence, other than motoring, or have any prosecution pending.
  • I have never had any insurer cancel, decline, refuse to renew or only accept on special terms, my liability insurance.
  • I have read and agree to the Insurance Product Information Document.Click here to read the Insurance Product Information Document.
  • I have read and agree to the Terms of Business of BMIB. Click here to view our Terms of Business.
  • I have read and agree to the Data Protection of BMIB. Click here to view our Data Protection.
  • I hereby declare and warrant that all the statements and particulars in this application are in all respects complete and true, that they are material, and that I have not suppressed or misstated any material facts and I agree that this proposal form shall be the basis of the contract with the underwriters and deemed to be part of the insurance coverage issued to me.
  • I consent to receiving emails from BMIB regarding my inquiry.
  • I consent to BMIB contacting me by phone for the purpose of arranging this type of insurance.

Your Duty of Care/Disclosure
It is your responsibility to provide complete and accurate information for insurers when arranging an insurance policy, throughout the life of that policy and when you are renewing it. It is important that you ensure that all information provided, and all statements made on proposal forms, statements of fact, claim forms, and other documents are, to the best of your knowledge and belief, complete and accurate. Specific questions will be asked. Where you do not provide additional information (after being requested to do so) it can be presumed that the information previously provided remains unchanged. Failure to disclose any material information to your insurers could invalidate your insurance cover and could mean that all or part of a claim will not be paid or your policy cancelled. An insurer may repudiate liability or limit the amount paid on foot of the contract of insurance, only if it establishes that non-disclosure of material information was an effective cause of the insurer entering into the relevant contract of insurance and on the terms on which it did. Completed proposal forms or Statements of Facts will be provided to you. These are important documents as they form the basis of insurance contract between the insurer and you the consumer. You should review and confirm that the answers contained within are true and accurate. If you have any doubts as to whether any information is material it should be disclosed.

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Please fill in the form below, then click "Next". The fields marked * must be completed, other fields may be left blank.

Title* e.g. Mr/Mrs/Ms
Your First name*
Your Last name*
Date of Birth*
Trading name (leave blank if none)
Limited company
Postal address line 1*
Postal address line 2*
Postal address line 3
County*
Eircode*
Country
Email address*
Telephone number
Mobile number*
Association*
Inception date Date when you would like insurance cover to start

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Please tick what you require cover for.

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Business Equipment Insurance - Cover up to €10,000 worth of your business equipment and trade contents for only €104.00.
Protect your equipment today with a simple, affordable addition to your policy.
Tick the below box if you wish to avail of the extra cover;

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Declarations

  • I understand that I must hold an approved qualification to carry out the treatments I have requested cover for. In the case of Business & Management Consultants where a specific approved qualification is not held, then it is deemed that “appropriate qualification” will be defined as having no less than 10 years relevant industry experience.
  • I am not a student but fully qualified.
  • Distance learning or online courses will only be accepted if they are CPD courses, not my main qualification. Unless approved by one of our approved associations.
  • I understand cover for CPD qualifications or manufacturer training will not be accepted as stand-alone qualification.
  • I understand that I hold an appropriate qualification for the cover I have applied for.
  • Please note that in the event of a claim proof of qualification and/or any such relevant industry experience may be requested.