Combined Liability Risk Submission

Complete the form below and an underwriter will review and respond within one working day. Fields marked * are required.

YOUR DETAILS

Your name *

Brokerage *

Email *

Phone

INSURED DETAILS

Insured name *

Inception date required *

Business address *

Years trading *

Number of employees

Include full-time, part-time and labour-only sub-contractors.

TRADE & BUSINESS ACTIVITIES

Trade / business description *

Please be specific — e.g. "general builder undertaking domestic extensions and refurbishments, no new build or structural work."

Annual turnover *

Annual wages & salaries

Does the business work at customers' premises or public places?

No — own premises only Yes — domestic Yes — commercial Yes — both

Does the business work at heights above 5 metres?

No Occasionally Regularly

Does the business carry out any hot works?

No Yes — details below

Hot works details (if applicable)

COVER REQUIRED

Sections required *

Public liability Employers liability Products liability

Public liability limit required *

Employers liability limit required

Geographic scope of activities *

UK only UK & EU Worldwide excl. USA/Canada Worldwide incl. USA/Canada

PRODUCTS & SUB-CONTRACTORS

Does the business supply, manufacture or install products?

No Yes — details below

Products details (if applicable)

Are sub-contractors used?

No Yes — labour-only Yes — bona fide Yes — both

Annual sub-contractor spend

Do sub-contractors hold their own liability insurance?

Yes No Some do

PREVIOUS COVER

Current / previous insurer

Current / previous premium

Reason for coming to market

Has cover ever been declined, cancelled or special terms imposed?

No Yes — details below

Declined / special terms details (if applicable)

CLAIMS HISTORY

Any liability claims or incidents in the last 5 years? *

No claims or incidents Yes — details below

Claims / incident details

Include any known circumstances which may give rise to a claim, even if no formal claim has been made.

ADDITIONAL INFORMATION

Anything else we should know?

Attachments

To attach a proposal form, existing policy, or claims history — please email these directly to [email protected] quoting the insured name and your submission reference.

We aim to respond within one working day.
Matrix Underwriting · FCA ref 537923

✓ Thank you — your submission has been received. An underwriter will be in touch within one working day.

Combined Liability — Risk Submission