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Help

Need HELP completing this form? Click on the icon to open help information.

Call FREEPHONE 0800 3287213

 
Your Quote:
Business Details
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Domiciliary Agencies

CARE
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Note: Fields marked* must be completed.

About Your Business

About Your Business help

Please leave a contact name and telephone number so we can contact you.
Please tell us what type of agency you are registered as: a domiciliary care agency, a nursers agency or an employment agency. This will enable us to obtain the correct insurance package for you.

If you give us your renewal date, we will contact you six weeks before renewal to offer you a free quotation.

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To which categories of service users do you intend to provide a service?

Categories of service help

Older People
Personal Carers
People with Mental Health Problems
Children
People with Learning Difficulties
People with Physical Disabilities
People with Sensory Loss
Others

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About Your Staffing Costs

About Your Staffing Costs help

Please tells us what you estimate your annual wage roll figures are likely to be for the forthcoming year. The figures need to be separated between what you estimate you will pay your clerical/admin staff and your caring staff next year.

If you are not a limited company, please provide the wage roll figures of the Proprietors. If the proprietor carries out any caring duties, please separate the wages between clerical and caring (e.g. if the proprietor spends 10% of their time caring for service users and earns £40K per year, you will need to put £4k in "Wages Carers" and £36k in "Wages Clerical / Admin").

If you are a limited company, you only need to complete the "All Other Employees" category. Please include your wages for the company directors in this section.

Please note that this information is what the quotation is based upon. Please be as accurate as possible. If you are unsure, it is better to overestimate the figures. At the end of the insured year the insurer will ask for your actual wage roll figures and will recalculate your quotation. If your original premium was too high, we will refund you the difference. If we have charged too little, we will ask you to pay a 'top-up'.

Note: if you are a limited company please include the wages of directors in the 'All other Employees' category.
Tell us about next years estimated wage roll figures.
  Wages Clerical / Admin ** Wages Carers **
Sole Proprietors / Partners £  per annum £  per annum
All Other Employees £  per annum £  per annum

Your Company Turnover

Your Company Turnover help

Please tell us what you estimate your company turnover will be for next year.

In order for us to get the best possible deal for your business, please tell us if you are a limited company. You must also tell us whether you have made any claims in the last five years (if you have we will require the claim information before we can quote. Please submit a separate sheet if necessary). We also need to know if you provide childcare and whether you are a registered domiciliary care provider.

Please tell us the amount of Public Liability and Treatment Liability that you require. Your local government will state how much you require by law. Please tick the corresponding box, so we can provide you with a quotation on the correct basis. Your Employers Liability will be at the standard £10m.

Is your company registered as a limited company?
Has your company made any claims in the last 5 years?
Do you provide childcare?
Are you a registered Domiciliary Care Provider?
What levels of Public Liability do you require?
What levels of Treatment Liability do you require?

About the Optional Cover

Optional Cover help

If you would like any cover in addition to our Core Package please tick the appropriate box. Buildings or Tenants Improvements can only be purchased if you buy the Office Package.

Tell us what additional cover you would like

(Contents value)