Pre-Renewal Form - Access Insurance

1Policy & Contact

2Income

3People

4Changes

5Declarations

Policy Details

Insured Name

Access Insurance Reference

Insurance Type

Insurer Reference

Renewal date

Primary Contact Details

Name*

First Name Last Name

Email Address*

Phone*

People

Does your organisation have:*

Employees

Contractors / Self-Employed / Freelancers

Volunteers

Members (Formal Members/Congregations)

Trustees / Committee Members

None of the Above

Number of Trustees / Committee Members

Total Number of Volunteers*

The total number of people in your volunteer pool.

Number of Active Volunteers*

The highest number of volunteers that might partake in an activity at one single point in time.

Total Number of Members/Congregation*

The total number of people your membership group or faith group considers to have as members or congregants.

Number of Active Members/Congregation*

The highest number of members that might partake in an activity or gather at one single point in time.

Types of Staff*

Please select whether you have staff in any of the following categories. Select all that apply.

Types of Staff and Wages*

Please provide details of numbers and wageroll for each type of staff you selected. Without this additional detail an underwriter may need to rate as if all roles were manual or high risk which may increase the premium.
For the purposes of this form, full-time employment (FTE) is defined as a 35-hour working week.

Role i.e. type of employee (as selected previously)

Total Number of staff

Full time equivalent staff .i.e..: 7.5 FTE

Wageroll (£) i.e. £75,000

Types of Contractors*

Select all that apply.

Types of Contractors and Wages*

Please provide details of the contractors you use and their annual wages as well as whether they have their own insurance.

Role i.e. clerical, catering, maintenance, carers etc

Bona-fide (with own insurance) or Labour only (without own insurance)

Amounts paid to them in total (£) i.e. £55,000

Drivers

How many drivers do you have?*

What is the youngest driver's age?*

What is the oldest driver's age?*

Preparing for your renewal

Policy Details

Primary Contact Details

Income

People

Drivers

Organisation Changes

Activity Changes

Property Changes

Motor Changes

Travel Changes

Governance

Claims

Disclosures

Actors or performers
Adventure Centre Works (ex activities)
Adventure Centre Works (inc activities)
Adventure Centre/Sports Instructors
Animal welfare
Building maintenance (construction work; not height)
Building maintenance (not construction/height work)
Carers (care home only)
Carers (rehabilitation unit)
Caretakers
Caterers
Cleaners
Clerical/Administration
Clothing manufacturer/seamstress
Cooks/canteen (kitchen assistants)
Domiciliary care
Drama/Artistes
Drivers (Private cars) & sales reps
Drivers (Van & GCV – haulage)
Electrical Engineers (studios/offices)
Electricians (self-employed)
Electronics/assembly
Estate management (not construction/height work)
Fundraisers (street collection, stalls, fetes)
Gardener (market gardener)
Gardener/groundsperson (including tree surgery)
Gardener/groundsperson (excluding tree surgery)
Height workers/restoration staff
Maintenance work (buildings)
Manual workers (not otherwise specified)
Manufacturing
Musician
Nursery/playgroup workers
Nursing staff
Packers (warehouse/factory)
Porters
Printers (machinery)
Printers/VDU (desktop only)
Shop assistants
Social workers (including community workers)
Studio operators (recording)/computer engineers
Teachers/tutors/trainers (ex sports)
Technicians (IT, studio, etc.)
Therapists (not medical practitioner, nurse, carer)
Warehouse staff
Woodworking (computer controlled machinery)
Woodworking (powered machinery)
Woodworking/carpentry (handtools)
Youth workers

Actors or performers
Adventure Centre Works (ex activities)
Adventure Centre Works (inc activities)
Adventure Centre/Sports Instructors
Animal welfare
Building maintenance (construction work; not height)
Building maintenance (not construction/height work)
Carers (care home only)
Carers (rehabilitation unit)
Caretakers
Caterers
Cleaners
Clerical/Administration
Clothing manufacturer/seamstress
Cooks/canteen (kitchen assistants)
Domiciliary care
Drama/Artistes
Drivers (Private cars) & sales reps
Drivers (Van & GCV – haulage)
Electrical Engineers (studios/offices)
Electricians (self-employed)
Electronics/assembly
Estate management (not construction/height work)
Fundraisers (street collection, stalls, fetes)
Gardener (market gardener)
Gardener/groundsperson (including tree surgery)
Gardener/groundsperson (excluding tree surgery)
Height workers/restoration staff
Maintenance work (buildings)
Manual workers (not otherwise specified)
Manufacturing
Musician
Nursery/playgroup workers
Nursing staff
Packers (warehouse/factory)
Porters
Printers (machinery)
Printers/VDU (desktop only)
Shop assistants
Social workers (including community workers)
Studio operators (recording)/computer engineers
Teachers/tutors/trainers (ex sports)
Technicians (IT, studio, etc.)
Therapists (not medical practitioner, nurse, carer)
Warehouse staff
Woodworking (computer controlled machinery)
Woodworking (powered machinery)
Woodworking/carpentry (handtools)
Youth workers