Hotels - Combined Proposal Form
Crest Underwriting L
imited is a Provisionally Accredited Lloyd's Broker.
Crest Underwriting Ltd is a Provisionally Accredited Lloyd’s Broker
Crest Underwriting Limited is regulated by the Irish Financial Services Regulatory Authority as a Multi Agency Intermediary.
Crest Underwriting Limited is not itself an insurance company and does not underwrite any risk in respect of any policy arranged on
the basis of the information contained or attached to this proposal form.
HOTELS – COMBINED RISKS SUBMISSION FORM
The undernoted form can be completed as a submission form or, as we are aware that brokers produce
their own risk submissions, the following should be used as a checklist in respect of information to be
contained in the brokers submission.
The information requested below is the minimum required by London Market in order to obtain a quality
quotation. Any additional information that can be provided where relevant will obviously assist but we
must reiterate that the information requested below is the minimum required.
Where a quotation is required in respect of additional business classes, please attach details of the cover
required, sums insured/limits and claims experience.
Risk Location (s):
Full Business Description
(including summary of Activities) :
Current Insurer (s):
Premium Last Renewal:
How long under present ownership:
Number of letting bedrooms / Maximum no. of guests: B: | G:… …….
Number of Stories:
Building Construction: Brick/Stone/Concrete/Other/Grade I/ Grade II €
Property including car Parks not on Hotel site Yes/No:
Is Subsidence cover required? Yes/No:
Is there any portable heating by means of liquid petroleum, gas,
propane etc. Yes/No:
If yes, are these heaters fixed in place and attached to walls? (or advise
other security conditions including at least one metre clearance from any
Roof: Construction (e.g. slate/tile/thatched/flat etc):
Contents of the (including private apartments) (excluding €
Stock of Wines, Spirits & Tobacco €
All other Stock: (ie. food, beer & other
Guests Effects up to €1,500 per guest
x number of guests €
* Do you have a Night Porter? Yes/No:
* Other forms of Security? Yes/No:
* Are the premises alarmed? Yes/No:
* Details of system:
Loss of Frozen Stock: €
All Risks: (ie. including cover away from the premises), Jewellery on
and off the premises.
Personal Effects eg. Cameras, Golf Clubs, Clothing etc. €
Loss of Revenue: (12 months Indemnity Period) ie. Annual Income €
Loss of Licence: €
Book Debts: €
Public/Products Liability: €1.3 million
Employers Liability: €13 million
Please advise Annual Turnover €
Please advise Annual Wage Roll: Clerical €
Cash in Transit or on the premises during business hours/locked in safe €
Is there a safe on the premises Yes/No
Increased amount (if required) subject safe details €
Name of Hotel:
Any claims in the last five years (Please detail on the attached form) Yes/No:
Ever been refused Insurance or ever had special terms imposed? Yes/No:
Do you hold Discos, Live Entertainment or similar functions open to the
Public (other than Private Functions): Yes/No:
If the answer is Yes please complete attached Entertainment Questionnaire
Type of Licence Restaurant & Residential/Full/Unlicenced
Do you undertake outside catering (if Yes state Turnover) €……………. Yes/No:
Is there a Swimming Pool & if so who uses the Pool - Guests or the General
Public? Are there any Disclaimers, Lifeguards or qualified Swimming
Instructors? – FULL DETAILS PLEASE INCLUDING DEPTH Yes/No:
Is there a Solarium/Gym/Sauna/Health Club? Who uses the Club and who
is responsible for the running of the Club? Are the Staff qualified? A full
range of activities undertaken is required – FULL DETAILS PLEASE Yes/No:
If run by an outside organisation do you check their PL insurances for a minimum
Limit of €2m? Yes/No:
Leisure Activities or Excursions organized by the Hotel eg. shooting,
fishing, etc (Please give details) Yes/No:
Any vehicles not licenced for road use other than Lawn Mowers Yes/No:
Is there a Laundry Service for Guest & Public? Yes/No:
If so state Details of Turnover €
Distance from nearest full time Fire Brigade Miles
Is the business seasonal? If so, state period of closure and details of
occupancy during closer
Age of Electrical Installation: / When last inspected
Are you in a long-term agreement? Yes/No:
If yes please indicate Expiry Date:
Name of Hotel:
1) Has the site ever suffered from flood, wind storm or subsidence damage? Yes/No:
2) What is the distance to the nearest river, stream, reservoir etc?
3) Have flood protection schemes been introduced since this flooding to prevent
re-occurrences? If “Yes” provide details
2) Is the site located in an exposed position or on top of a hill? Yes/No:
If the answer to either of the above questions is Yes – Insurers require full details
Please note that if you have any outbuildings the following conditions apply:
1) Minimum level of security required – five levered close shackle padlock.
2) Do you have any items valued at over €500 per item Yes/No
a) Maximum value any one item €
b) Maximum value all items €
c) Details of items kept in Outbuildings
CLAIMS HISTORY LAST 5 YEARS
Date Details of Claim Amount Outstanding/ Precautions Taken
LIVE ENTERTAINMENT QUESTIONNAIRE
NAME OF VENUEL:
1) Do you have an entertainment licence?
2) Licencing Hours: Do you apply for extensions past 23:00 hours?
If yes, please advise Licencing hours
How many nights per week?
3) Is there any admission charge?
4) What is the licenced capacity of the premises?
5) Do you have a dance floor or allow dancing in any area?
6) Size of dance floor in square feet
7) How many disco’s/live entertainment per week?
8) Please state average attendance levels for any live entertainment
9) Please advise the annual turnover for any live entertainment
10) Please advise annual wage roll for any live entertainment
11) Do you hire doormen?
12) If yes, are they employed by an agency?
List below all types of entertainment you provide or intend to provide
Coverage is subject to:
1) Compliance with all Local Authority requirements.
2) No previous closure or prosecutions by Local Authority, Health Safety Executive or Police.
3) No previous Policy attention or warning, as formal or informal, in connection with illegal drug use, violence or incidents within/outside the
building or any offensive weapon incident.
This declaration will form part of the insurance contract and as such all circumstances likely to affect the risk must be declared and no material fact
or other circumstances likely to affect the risk should be omitted.