The Professional Indemnity for Solicitors - Quotation Form

Information for Solicitors about Professional Indemnity Insurance

If you have already completed your renewal form send it to us by

fax 0845 280 2443

or e-mail simon@heritage-insurance.co.uk

To obtain your quotation please submit the on-line form below * = required field

1. Name and Address details

Practice Name: *
SRA Registration Number:
Main Office Address :
Post code:
Main Office Telephone: *
Main Office Fax:
Practice Web Site:
Contact E-mail: *
Date Established
Is your practice an incorporated practice? Yes No
Do you have any other offices, other than the main office listed above, for which you are seeking cover ? Yes No
If yes please list the addresses

2. Prior Practices - please list the names of all prior practices to which this practice is a successor practice

Name of practice	Date Established	Date of succession




Have any of your practices above reported any circumstances, incidents or claims in the last 5 years ? Yes No If yes please refer to question 7

3. Solicitors details - give information for Principals, Assistants and Consultants

Title (Mr., Mrs., other)	Solicitors Full Name	Date of Birth	Solicitor status (Principal/ Assistant/ Consultant)	Full/Part Time	Roll Number (as shown on practising certificate)

4. Other Staff

Number of non-solicitor fee earning staff :
Number of all other staff:

5. Practice Fees

Total gross fees for the last annual accounting period or, if you are a new practice, estimated fees for the coming year
Does any one client or group of clients generate 20% or greater of your annual fees ? Yes No

6. Practising certificate - in the last 10 years has any fee-earner in the practice:

Ever been refused a practising certificate?	Yes No
Ever been granted a conditional practising certificate?	Yes No
Been reprimanded fined or otherwise sanctioned by the disciplinary tribunal?	Yes No
Been reprimanded by the Disciplinary Tribunal	Yes No
Practised in a firm subject to investigation or an intervention by the Law Society (including the Solicitors Regulation Authority)?	Yes No
Had an award for inadequate professional service made against them by the Legal Complaints Service or the CCS or OSS	Yes No
Had a civil or criminal judgement against him or her?	Yes No
Been investigated by another regulatory body other than the law society (e.g.. FSA)	Yes No
If YES to any of the above please provide details below

7. Claims and circumstances

Has your practice, or any prior practice, reported any circumstances, incidents or claims to the Solicitors Indemnity Fund (SIF), the Assigned Risks Pool or to Qualifying Insurers in the:
Insurance Year 2005-2006	Yes No
Insurance Year 2006-2007	Yes No
Insurance Year 2007-2008	Yes No
Insurance Year 2008-2009	Yes No
Insurance Year 200-2010	Yes No
If YES to any other insurance year, please provide claims information from other Qualifying Insurers or the Assigned Risks Pool for all circumstances, incidents or claims reported since 01/09/2000 by your practice and any practice to which you are a successor practice by e-mail to solicitors@heritage-insurance.co.uk or fax 0845 280 2443
Have any circumstances, incidents or claims reported by you or any prior practice in the last 5 years arisen as a result of the dishonesty of any principal or employee of the practice?
Yes No
If YES please give details below including how the matter was resolved and the procedures/processes in place to avoid re-occurence

After making full enquiry of all principals and employees of your practice are you aware of any circumstances, incidents or claims that you have not reported to your current or any prior insurers?
Yes No
If YES please explain below

8. Current coverage

Are you currently in the Assigned Risks Pool ?

Yes No

If YES please explain below

Has any qualifying insurer refused to offer your firms terms for professional indemnity insurance?

Yes No

If YES please explain below

Please provide details of your current insurance below

Current Insurer	Limit £	Excess £	Premium £

9. Area of Practice

Area of practice (rounded to nearest whole %)	%
Administering oaths, taking affidavits and notary public
Agency Advocacy
Arbitration, Adjunction and Mediation
Children, Mental Health Tribunal and Welfare
Commercial / Corporate Work (excluding work related to public companies)
Conveyancing - Commercial
Conveyancing - Residential
Criminal Law
Debt Collection
Defendant litigious work for insurers, Defendant Personal Injury Work
Employment - contentious
Employment - non-litigious
Financial Advice and Services regulated by the Solicitors Regulation Authority
Immigration
Landlord and Tenant
Lecturing and Related Activities and Expert Witness Work
Litigious work other than given in any other category
Matrimonial / Family
Non-litigious work other than given in any other category
Offices and Appointments
Parliamentary Agency
Personal Injury (Claimant)
Personal Injury (Defendant)
Property Selling, Valuations and Property Management
Town and Country Planning
Wills, Trust and Tax Planning
Probate and Estate Administration
Commercial / Corporate work for public companies
Financial Advice and Services where your practice has opted into regulation by the FSA.
Intellectual Property including patent, trademark and copyright.
Note total must =100%
Do you provide management services or investment advice to any entertainment clients or sporting professionals?
Yes No If YES please explain below

Has your practice or any proir practice accepted instructions for any class actions or other group litigation?
Yes No If YES please explain below

With which Legal Services Commission Quality Marks or other quality standards, eg. LEXCEL or Investors in People is your firm currently accredited? Please specify below

10. Requested Cover

Please advise limits of indemnity for which quotes are required

Please advise limits of excess for which quotes are required

11. Significant change

Do you expect there to be any significant change to or in your practice in the coming year?
Yes No
If YES please e-mail details to solicitors@heritage-insurance.co.uk or fax 0845 280 2443

12. Other Material Information

Is there any other material information that may be relevant to this application?
Yes No
If YES please e-mail details to solicitors@heritage-insurance.co.uk or fax 0845 280 2443

13. Risk Management

General

Do you have a formal risk management strategy?

Yes No

Do you analyse and/or review your complaints and claims on a regular basis?

Yes No

If "NO" to either of the above, please advise below how you deal with handling complaints, ensuring instructions are fully understood and recorded or that conflicts will not result

Are you accredited with LEXCEL?

Yes No

If "YES", please advise date of accreditation

Do you always use client rule 15 letters?

Yes No

Do you always use a Retainer/Engagement letters?

Yes No

Do you have a formal conflicts search procedure in place when opening new files?

Yes No

If "NO" to any of the 3 questions above, please advise how you deal with handling complaints, ensuring instructions are fully understood and recorded or that conflicts will not result:

Supervision & Delegation

Are regular audits undertaken of assistant and Fee Earner files?

Yes No N/A

Administration and Organisation

Is all incoming post first seen by a Principal or Department Head before distribution?

Yes No

Do you have a formal policy that determines when it is considered safe to destroy old files?

Yes No

Do you operate a diary system?

Yes No

If "NO", please provide details of the department diary system(s) used:

In the absence of all Principals & fee Earners are proceedures in place for dealing with their workload?

Yes No

If "NO", please explain workload procedures:

Training & Education

Does the firm have procedures for keeping Fee Earners up to date with Law changes applicable to their work area?

Yes No N/A

If "NO", please provide details:

Money Laundering

Does the firm have a formal Money Laundering policy

Yes No

Do you implement client identification checking procedures in all work areas?

Yes No

If you experience problems with the on-line quotation form please contact us

Financial Services Agency number - 447154