Insurance & Reinsurance Brokers at Lloyd’s
+44 (0) 20 7977 5700

Microlight Proposal Form

Proposer

Address

Contact Details

Microlight Details

Usuage

Storage

select as many as appropriate

Microlight Value


Usuage

Storage

select as many as appropriate

Microlight Value


Usuage

Storage

select as many as appropriate

Microlight Value


Usuage

Storage

select as many as appropriate

Microlight Value


Usuage

Storage

select as many as appropriate

Microlight Value

Pilot Details










Insurance

Data Protection & Privacy

Our policy and procedures comply with all known legislation involving the collection, use, storage and disclosure of personal information. You are entitled to access the information we hold concerning you and we can supply a copy of our full policy and procedures on request.

We, and our agents, need to collect, use and disclose your information in order to consider your application for insurance and provide the cover you have selected, administer your policy and handle any claim. This may involve disclosing your information to third parties who assist in providing such services.

If you provide information concerning another person who you represent, e.g. as their broker or agent, you are confirming that you have made them aware that their information is being disclosed to us and that you have their authority to do so.

By supplying personal information to us you are confirming that you have understood the above and that it meets with your approval.

Declaration

Please note the following information, which is dependent and relevant on whether you are a proposed consumer or business insured:

If you are a consumer insured (i.e. a person buying insurance wholly or mainly for personal purposes unrelated to your employment), you have a duty to take reasonable care to answer questions fully and accurately, and that any information you volunteer is not misleading. This duty exists before the cover is placed, when renewed, or altered at any time throughout the duration of the policy. If you do not do so, your Insurer may be able to void your policy from inception.

The Insurance Act 2015 contains new measures which we need to bring to your attention as a Business Insured (i.e. an insured buying insurance wholly or mainly for purpose related to their business).

You have a duty to disclose every material circumstance you know or ought to know, after reasonable search. This applies before the cover is placed, when renewed and if altered at any time during duration of the Policy. A circumstance is material if it would influence an Insurer’s decision whether to accept the risk, including its terms and pricing.

If you are in any doubt whether a circumstance is material to the risk, it should be disclosed, as failure to disclose may entitle your Insurer to either void the Policy from inception or impose different terms. Any claims made would either not be paid or may be reduced in value.

Where there are Warranties, Conditions Precedent or any onerous conditions applicable to your insurance policy, failure to meet such conditions could invalidate the cover (and hence no claims would be paid), or suspend cover until such warranty etc, is remedied (and any claims during the suspension period may not be paid).

I agree to inform Insurer’s of any changes in my circumstances from the date of this Application and understand that cover will not commence until the Policy, Certificate or Acceptance Letter has been issued.

I declare that the information given is true and complete to the best of my knowledge and belief. By clicking ‘Submit Proposal’ you are agreeing to our standard terms of business agreement, the details of which can be found here