Let's start with your name or company name.

Please be as accurate as you can. It will help us understand your situation so we can help to find you a solution.

Tell us about the business.

Please be as accurate as you can.

What’s happening?

Please share with us the problems you’re facing with insurance.

Please tells about your premium.

Tell us the current or renewal premium you or your clients are facing. You don’t have to be exact!

Thanks for your support!

By taking the time to share your experience, we can quickly confirm the usefulness and feasibility of a new self-insurance pool for Professional Indemnity. We’ll keep you informed about the progress towards creating a self-insurance pool.

Next step

Thank you

And one more thing, invite others, The more customer interest we have, the more likely we’ll be able to create a new Self-Insurance Pool. So please, if you know of others who are experiencing the same pain with their Professional Indemnity insurance. Share this form with them.
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