For Colleagues
Compliance and Accessibility
Provide details of special requirements.
Contact Details
Organisation Details
How many? Profit/non-profit? | Are they wholly owned or separate? | what activities, same aims/objectives? | Same board of trustees / management? Same banking arrangements?
Location and Website
Where and how is alcohol provided? | Do you hold a liquor licences either permanent or temporary? | Do you have a premises with a bar?
If so – Are staff or volunteers trained to refuse service to underage or intoxicated individuals? | What hours do you serve alcohol at a premises? | How many alcohol related events do you run each year? | What is the premises size? | Do you have door security? | Who supplies the alcohol? | Is there a written policy for managing alcohol related risk
Please provide full details of the contact sports undertaken including the type of sport and whether participation is for members only or the general public | the age range, experience level and typical number of participants | details of training, matches and venues used (owned or hired) | the qualifications and supervisory ratios of coaches or referees and any governing body affiliation | the risk assessments, rules, protective equipment and injury management procedures in place | the use of consent forms and safeguarding arrangements where children or vulnerable adults are involved | the first aid and emergency procedures available at training and events | whether any activities involve competitions, leagues, tours or overseas travel.
Please provide full details of the activities undertaken including the disciplines involved and whether they are for members only or the general public | the age range, experience level and typical number of participants | all locations and environments used (UK or overseas, indoor or outdoor, owned or third-party) | the qualifications and supervisory ratios of instructors and any governing body affiliations | the risk assessments and safety management procedures including equipment inspection and maintenance | participant screening, briefings, consent and safeguarding arrangements where applicable | the emergency, first aid and rescue procedures in place | whether any activities are unsupervised, at height above standard climbing walls, in remote areas or in winter/alpine conditions.
Where is the trip taking place? | How many days and nights will the whole trip be? | How many services users will attend and how many staff/volunteers will be present? | What activities will be run by you and what activities will be run by third parties? | Do third parties have their own public liability insurance in place? | Will children and or vulnerable adults be attending? If yes, will all volunteers and staff have DBS checks, will applicable ratios be adhered to, is there a child protection and or vulnerable adults policy in place and are risk assessments carried out for the trip and its activities? | What are the arrangements for transportation and accommodation – is this arranged by you or a third party | Are there any other trips planned? | Are risk assessments carried out for the trip?
Will this be hand tools only or machinery | If machinery is used what type? | Any fixed power machinery? | Are automatic cut off devices fitted to equipment where necessary? | Is appropirate PPE worn? | How often does manual work take place and how much involves machinery | Do you have a manual handling policy in place | Will all volunteers and staff receive training to use equipment safely | Will manual work and machinery use be risk assessed | Is high risk machinery limited to qualified or experienced individuals | Are areas of work kept cleared of debris? | Is supervision provided where necessary | Are qualifications/competence for using machinery in place | Is the machinery hired in or owned and maintained by you | If maintained by you is there a maintenance programme to ensure it is fit for purpose
What is the maximum height you will be working at | What work will you be doing at height | How much work at height will you do in a year | Who will be working at height and do they have adequate training or qualifications | Will equipment be required such as ladders scaffolding or ropes | If so what equipment will be used and is it owned by you or hired in | Is the equipment maintained by you or a third party | Has the work at height been risk assessed
For bonfire events: How many people will attend the event | Will the bonfire be cordoned off from the public | Do you have the landowners permission | Have you risk assessed the event and held similar events before | Will you use any flammable substances to ignite the fire and if so what | Do you have fire extinguishers on hand and will the bonfire be fully extinguished at the end of the event | How large will the bonfire be and what materials will be burned.
For non-event bonfires: How big are the fires in square metres? | How far is the nearest structure or shrubbery from the fire | What steps do you take to ensure the fire is controlled? | Is the fire ever left unattended? | Is the fire put out 1 hour+ before leaving site?
How many people will attend the event | Will the fireworks be cordoned off from the public | How far will people be kept from the ignition site | Do you have the landowners permission | Have you risk assessed the event and will first aiders be present | Have you held similar events before | Will staff and volunteers be trained to operate fireworks safely | Do you comply with HSE guidance on firework displays and storing and selling fireworks | Do all fireworks conform to British Standards | If no professional pyrotechnic is employed please confirm only fireworks labelled as Categories 1 2 or 3 under the Pyrotechnic Articles Safety Regulations 2010 will be used | Please confirm that fireworks will not be modified except fitting manual or electric fuses | Will sparklers be used by attendees | Please confirm there will be no storage or transport of fireworks outside the event site perimeter | Will Chinese lanterns be used by attendees
How many people will attend the event | Will the fireworks be cordoned off from the public | How far will people be kept from the ignition site | Do you have the landowners permission | Have you risk assessed the event and will first aiders be present | Have you held similar events before
Are these trips organised by you or a third party tour operator | Which countries will you be travelling to | Duration of trips average and maximum | Will you visit any countries against Foreign Office advice | How many people will travel on each trip average and maximum | What activities will be carried out abroad clerical or any manual work | If manual work what will be done and what training and personal protective equipment will be provided | Will travel insurance be arranged by you or by individuals | Are there any non UK nationals requiring cover | Is there any non UK domiciled property requiring cover
What animals do you work with | How many animals do you work with at any one time and over a year | What work do you do with the animals | How long do animals stay with you | Are volunteers and staff trained to work safely with the animals | Do you work with any dangerous animals including dogs listed under the Dangerous Dogs Act | Is any medication or treatment administered | Do you microchip animals or is this done by a qualified third party | What security measures are in place to prevent escape | Is personal protective equipment used and if so what | Do you arrange animal fostering | What animals are fostered | How do you vet the foster family | How long are animals fostered for | Will the foster home include any under 18s | How do you match animals to foster homes | What risk assessments are carried out on the foster family
Do you prepare cook or serve food | Where does food preparation take place for example your own kitchen a hired venue or outdoors | Are those handling food trained in food hygiene and food safety | Is deep fat frying or use of hot oil carried out | If yes is a thermostatically controlled fryer used and is a fire blanket or extinguisher available | Do you have written food hygiene procedures for example allergen controls and temperature checks | How often do cooking activities take place | Are members of the public involved or only your own group | Do you cater for large events or high footfall | Are there any vulnerable groups such as children or older adults being served
What care or treatment do you provide and is this domiciliary care | Who do you provide care or treatment to | How often is care or treatment provided | Do you administer medication and to what extent | Are staff trained and qualified for the care or treatment provided | Are you registered with CQC and if not why not | Do you provide any overnight residential care | Do you use specialist equipment or machinery | Do you provide any medical advice or services
Please provide full details of the water-based activities undertaken including the type of craft or sport and whether participation is for members only or the general public | the age range, experience level and typical number of participants | all waters used (e.g. swimming pool, inland water, coastal or offshore) and whether locations are owned or third-party | the qualifications and supervisory ratios of instructors, lifeguards or safety boat cover and any governing body affiliation | the risk assessments and safety procedures in place including weather, water conditions, buoyancy aids/PPE and equipment inspection and maintenance | participant screening, swimming competency checks, briefings, consent and safeguarding arrangements where applicable | the rescue, first aid and emergency procedures in place | whether any activities involve powered craft, open water, overnight trips, competitions, hire to third parties or overseas travel.
Please provide full details of the motorised vehicles used including the type (e.g. plant, go-karts, ATVs, ride-on mowers) and the purpose for which they are operated | whether use is by staff, volunteers, members or the general public and the age restrictions and typical number of users | the locations and surfaces on which they are operated and whether these are owned or third-party premises | the training, competence requirements and supervision arrangements for operators | the inspection, maintenance and key/security controls in place | the risk assessments and safety measures including speed restrictions, segregation from pedestrians, barriers, signage and PPE | the arrangements for fuelling, charging and storage | the first aid and emergency procedures in place | whether any vehicles are hired out, used for events, competitions or off-site activities.
Nature of the goods and activities | What goods are sold, supplied or repaired and are they new, second-hand or refurbished | Do any items fall into higher-risk categories such as white goods or electrical appliances | Do you work on refrigeration equipment or items containing gases or pressure systems | Do you use tools that generate heat as part of the work including soldering irons, heat guns, welding or similar equipment | What is the annual income from these activities | Approximately how many transactions or repair jobs are completed each year | Are any repairs safety-critical | What testing or quality checks are carried out before items are sold or returned to customers | What inspection, cleaning or refurbishment processes are in place, particularly for electrical items and white goods | Is the work undertaken by employees, volunteers or subcontractors | What training, competency or supervision arrangements are in place | Do you conduct PAT Testing and is the person doing this suitably qualified?
Number and types of inflatables such as bouncy castles or slides | Age and condition of equipment | Maximum number of users allowed at one time | Are age or height restrictions enforced and users segregated if needed | Is supervision provided or left unattended | Are staff and volunteers trained in setup supervision and emergency procedures | Used indoors or outdoors and where | Is a risk assessment completed before each use | Are safety mats used around the inflatable | Is the inflatable securely anchored such as stakes or sandbags | Is weather monitored including wind speed limits and action taken if conditions become unsafe | Is the inflatable regularly inspected and maintained and by whom | Does equipment comply with BS EN 14960 safety standards | Who is the inflatable hired out to and how often | Does the inflatable have a current PIPA certificate in line with the manufacturers recommendations
Number and types of inflatables such as bouncy castles or slides | Age and condition of equipment | Maximum number of users allowed at one time | Are age or height restrictions enforced and users segregated if needed | Is supervision provided or left unattended | Are staff and volunteers trained in setup supervision and emergency procedures | Used indoors or outdoors and where | Is a risk assessment completed before each use | Are safety mats used around the inflatable | Is the inflatable securely anchored such as stakes or sandbags | Is weather monitored including wind speed limits and action taken if conditions become unsafe
(What advice, how often, income generated advice, what level of advice is given what qualification and experience do advice givers have, how many give advice – frequency.)
Please include the maximum attendance at any event and a description of the types of events you are planning. Where are the events held?
Your Income
Your People
Please describe how your group operate without employees, volunteers or members.
Your Risk Management
What work do you do with such groups and how often?
Are there any tenant’s improvements? Fixtures and fittings? High value items? Fine art or antiques? Special equipment? Cover required away from premises? Catering equipment? Medical equipment? Fridges/freezers and refrigerated contents? Where are contents stored?
Further property questions in next section. Last survey? Confident in your sum insured? 80% of UK ‘commercial’ buildings are underinsured. Insurers reduce claim payments of any size if there is underinsurance. Underinsurance and RCA article.
What are the values or periods of indemnity for business interruption, including:
– Increase cost of working
– Loss of income
– Additional ICOW
– Loss of rent receivable
– Loss of rent payable
Property and Security Details
Expected unoccupancy, maximum period of unoccupancy, details.
Floors:
Number of floors | Floor construction | Occupancy details of floors
Composite panels:
Type of insurance core in panels | Proportional of overall wall area | Proportion of overall roof area
Fire:
Fire Risk Assessment | Type of heating | Commerical/domestic kitchens | Deep fat fryers | Volume of flammable liquid | Insulation
OTHER:
Non-ferrous materials
Heating
Grade listing
Good state of repair
Outbuildings
Planned works
Shutters or other security features
FLOOD:
1. Any history of flooding at the premises? (dates/cost/details)
2. Any flooding in the surrounding area within last 10 years?
3. Near a water source? | Within 250m of river, stream, sea, or tidal water?
4. Basement present? Used for storage?
5. Critical services (electrics/IT/boilers) at ground floor or below?
6. Flood resilience measures in place (barriers, pumps, raised sockets etc.)?
7. Formal flood plan in place?
SUBSIDENCE RISK:
1. Any history of subsidence, heave, or landslip? (dates/details)
2. Any ongoing movement or monitoring?
3. Any underpinning carried out? (date & completion certificate available?)
4. Trees within influencing distance of building?
5. Property built on known shrinkable clay?
6. Any neighbouring properties affected?
Do you own or lease the land?
Is it used for recreation, agriculture, car park, other?
Is public access allowed?
Any history of flooding, landslip, subsidence, unstable ground?
Any contamination or pollution on site?
Any trees, embankments, steep slopes?
Boundaries: Fences, gates, rights of way?
Are there outbuildings, structures, sheds, greenhouses, playgrounds?
Are there any water features on site?
Any livestock or animals present?
Any previous claims relating to land?
Interested party | Property | Nature of interest | Agreement Number
Details of locations, construction of walls, roof, deadlocks, alarms, signalling mechanisms, CCTV, security, fire alarms. Living on or next to premises? Outbuildings, flood or subsidence risks.
Claims
Please include the date, circumstances and financial loss.
How did your insurer respond to the claim? Were there any claims that were not covered? How did you find the experience? Any mitigation against a future occurrence happening?
Adverse History Declarations
Type of issue (Cancellation, voidance, refusal or special terms imposed) | Reason given by insurer (non disclosure, claims losses, or risk improvements) |Date of issue | Insurer involved | | Position (Resolved new terms agreed or ongoing)
Nature of the conviction | Brief description of the offence | Date of conviction | Was a custodial sentence given | Is the conviction spent under the Rehabilitation of Offenders Act | Their role in the group |
(We do not need the name of the individual at this stage)
Nature of the issue | Date of the issue | Month and year if possible | Current status (satisfied, resolved, ongoing) | Role of the individual involved (We do not need the name of the individual at this stage)
Which regulator or authority involved? | Nature of the investigation / prosecution
Date of investigation | Outcome or current position (closed, ongoing, improvement required)
Fair Presentation
Before entering into a contract of insurance, it is your statutory duty to make a fair presentation of your risk. You have a duty to disclose all material facts that may influence an insurer’s decision to provide coverage or set premiums. Failure to do so may result in denial of claims or cancellation of my policy.