Commercial Combined 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

TRADE & BUSINESS ACTIVITIES

Trade / business description *

Annual turnover *

Annual wages & salaries

Does the business work away from its own premises?

No Yes — UK only Yes — EU Yes — Worldwide

Does the business export goods?

No Yes — EU Yes — USA/Canada Yes — Worldwide

PREMISES

Construction type *

Year built

Premises ownership

Owned Leased / rented Multiple premises

Security measures in place

SUMS INSURED

Buildings sum insured

Tenants improvements

Contents & stock sum insured *

Include stock, plant, machinery, fixtures & fittings.

Plant & machinery sum insured

Goods in transit sum insured

Any single high value item over £10,000?

BUSINESS INTERRUPTION

Gross profit sum insured

Annual gross profit or turnover less purchases.

Indemnity period required

Additional increased cost of working cover required?

No Yes

LIABILITY

Public & products liability limit *

Employers liability limit

Does the business supply, install or service products?

No Yes — details below

Products details (if applicable)

Any sub-contractors used?

No Yes — details below

Sub-contractor details (if applicable)

COVER REQUIRED

Sections required *

Current insurer (if renewal)

Current premium (if renewal)

Reason for coming to market

CLAIMS HISTORY

Any claims in the last 5 years? *

No claims Yes — details below

Claims details

ADDITIONAL INFORMATION

Anything else we should know?

Attachments

To attach a schedule, existing policy, survey or accounts — 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.

Commercial Combined — Risk Submission