Fillable LegalEx-PII-Prop-Form-2017 Final M004-18

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LegalEx-PII-Prop-Form-2017 Final M004-18

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Solicitors Professional
Indemnity Insurance
Proposal Form
Email to: info@legalexplus.com
For Enquiries Call: 0800 180 4203
Practice Name:
Solicitors Regulatory Authority Registration Number: Date Established:
Please include all names under which you practice and any other entities for which you are seeking cover, including Trustee and/or
Nominee Companies. Please provide a sheet of your headed notepaper.
Main Address:
Post Code: Website:
DX Number: Contact:
Telephone No: Fax No:
Name of person responsible for the
Professional Indemnity Insurance
Do you have any other offices, other than the main office listed above for which you are seeking cover? YES NO
If Yes, please provide details on a separate sheet. If there is no resident partner/member at any of these offices,
please identify the office concerned and explain how the office is supervised.
Is your practice an LLP or company registered at Companies House? YES NO
If it is an LLP, please provide a copy of your most recent statutory/management accounts.
1 Please list the names of all prior practices of which this practice is a successor practice (please see definitions at the back) in
the last 10 years. If necessary, list further details on a separate sheet.
Name of Practice Date Established Date of Succession
2 Have any of the listed practices reported any circumstances or claims in the last eight years? YES NO
If Yes, please refer to Part 8 below.
3 Has the Practice merged with or acquired any other Practice since 1st October 2008 YES NO
If Yes, please provide copies of any Run Off Cover (with a copy of the Run Off Endorsement) together with details of any claims
or circumstances notified by that Practice to Insurers within the last 6 years.
Is your firm licensed as an Alternative Business Structure? YES NO
Is the practice considering becoming an Alternative Business Structure within the next 12 months? YES NO
If Yes, please provide details of all proposals as currently known and include a copy of any application form and accompanying
documentation that has been submitted to the Solicitors’ Regulation Authority.
Solicitors Professional
Indemnity Insurance
Proposal Form
Email to: info@legalexplus.com For Enquiries Call: 0800 180 4203
Please provide a full answer to every question. The definitions at the end of this form should be read in conjunction with the form.
This form must be signed by Principal/Member of the practice.
Part 1 - Name & Address
Part 2 - Prior Practises
Part 3 - Alternative Business Structures
2
Email
Contact Telephone Number
Part 4 - Solicitor & Principle Details
Part 5 - Practice Fees
Please provide all information requested for every principal, member, assistant and consultant who will be employed by your
practice as at the policy inception. If any person listed is a Registered Foreign Lawyer or a Registered European Lawyer, please note
RFL or REL alongside solicitor status. (If you are a newly established practice, please enclose Curriculum Vitae for every
Principal/Member in your practice, your Business Plan and Cash Flow Statement). Please list additional solicitors on a separate
sheet.
Title
Title
Surname
Surname
Forename(s)
Forename(s)
Date of
Birth
Date of
Birth
Equity /
Non-Equity
Full Time /
Part Time
Full Time /
Part Time
Fee
Earner?
Date Qualified
Qualification
Roll No.
Regulatory
Body
Status (Principle/
Member/
Consultant/
Assistant)
Roll (HR, IT,
Finance,
Legal Executive,
Conveyancer etc.)
Number of non-solicitor fee earning staff: Full Time: Part Time:
Number of all other staff (inc secretarial): Full Time: Part Time:
Is the practice or any Principal of the practice, connected financially, or otherwise, with any other practice,
company or business for which it renders professional services?
If Yes, please provide details on a separate sheet.
On a separate sheet, please provide details of any joint venture or outside board positions held by anyone listed in Part 4 below.
1 The practice's accounting year end is:
2 Please provide gross fee income for the last three accounting periods and an estimate of gross fee income for the next
accounting period (or if you are a new firm the estimated fees for the first 12 months of practice):
Year Ending
2014
2015
2016*
2017 (estimate)
UK USA/Canada Elsewhere Total
*If not available please supply us with an estimate.
*Please state Equity or Non-Equity (E/NE)
Non Solicitor Principals
Please provide all information requested for every non-solicitor principal, member or director as at the policy inception.
YES NO
3
Part 6 - Client Types
Part 7 - Practising Certificate
1. Has any one client or group of clients generated 20% or more of your annual gross fee income
in the last three years?
If Yes, please provide full details on a separate sheet of the client and the work undertaken.
2. Does the Practice have any overseas offices?
3. Is the Practice represented at all in the USA or its territories and possessions or Canada?
4. Does the Practice give any foreign law advice?
If Yes, to questions 2-4 please provide full details on a separate sheet.
Please state percentage totalling 100% of gross fees arising from the categories of clients listed below:
Public Quoted Companies (Takeover & Merger & Share Issue work only)
Merchant Banks, Finance Houses, Hire Purchases and Credit Sales and other concerns providing Finance
(other than Building Societies)
Property Developers or Property Investment Companies (including their commercial conveyancing)
Sub-Prime Lenders
Insurance Brokers, Insurance Companies, Underwriting Agencies and similar organisations
(other than handling of claims under insurance policies)
All other clients
TOTAL
In the last 10 years has any Partner, Director, Fee-Earner, Employee or Consultant in the practice:
ever had a practising certificate refused, withdrawn or suspended?
been granted a conditional practising certificate?
been reprimanded, fined or otherwise sanctioned by the Solicitors Disciplinary Tribunal?
practised in a firm subject to an investigation or an intervention by the Solicitors Regulation Authority?
had an award for inadequate professional service made against him or her by the Legal Complaints Service
(formerly OSS/CSS/LCS) or entered into any regulatory settlement agreement with the SRA
had a civil or criminal judgment against him/her?
been investigated by any other regulatory body other than the Solicitors Regulation Authority
(e.g. FSA, ILEX)?
Acted as an intervening agent or taken over an intervened firm?
been (or is currently) the subject of an Independent Voluntary Arrangement (IVA) or other arrangement?
Has the firm been the subject of a monitoring visit from the Law Society or
Solicitors Regulation Authority in the last three years?
Has the firm ever been the subject of any visit or enquiry from the Forensic Investigation Unit of the
Law Society or Solicitors Regulation Authority or has notice of any proposed visit or enquiry been given?
If Yes to any questions in Part 7, please provide full details on a separate sheet and include a copy of all reports issued by the
Legal Complaints Service (formerly OSS/CSS/LCS), disciplinary tribunal and/or any other regulatory body.
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
%
%
%
%
%
%
100%
4
Has your practice, or any prior practice, reported any circumstances, incidents or claims to, Qualifying Insurers or the Assigned Risk
Pool in the:
Insurance Year 2011-2012?
Insurance Year 2012-2013?
Insurance Year 2013-2014?
Insurance Year 2014-2015?
Insurance Year 2015-2016?
Insurance Year 2016-2017?
If Yes to any insurance year, please provide details on a separate sheet, including claims information from Qualifying Insurers or
the Assigned Risks Pool for all claims and circumstances reported since 1st September 2010 by your firm and any firm to which you
are a successor practice.
After a full enquiry has been made, are you aware:
1. of any claims having been made in the last six years against any Partner, Principal, Member or
Director whilst in previous Practice.
2 of any circumstances, allegations, shortcomings or expression of dissatisfaction including any criticism
of the Practice’s work, which has led to or may result in any claim being made against the Practice or
any Partner, Principal, Member, Director, Assistant, Consultant or Employee either past or present,
whilst they were in Practice, or in previous Practice.
If Yes, to questions 1 & 2 please provide full details on a separate sheet including your opinion on both liability & quantum
3 any circumstances, or claims reported by you or any prior practice in the past, arisen as a result
of the fraud or dishonesty of any principal/member or employee of the practice?
If yes, please provide details on a separate sheet including how the matter was resolved and the procedures / processes in
place to avoid re-occurrence.
4 any circumstances, incidents or claims that have not been reported to your current or prior insurers.
If Yes, please provide details on a separate sheet.
PLEASE NOTE THAT YOU HAVE AN OBLIGATION UNDER YOUR CURRENT PROFESSIONAL INDEMNITY POLICY TO NOTIFY ALL
CIRCUMSTANCES AND CLAIMS AS SOON AS IS PRACTICABLY POSSIBLE.
1) Who provides your primary £2m (£3m for companies, LLPs)?
2) Who (if any) provides your Top Up insurance?
3) What is the total amount of cover?
4)
What is your current premium excluding IPT?
5) What is your current excess?
6) Has any solicitor referred to in Parts 1-4 ever been in the Assigned Risks Pool?
7) Have you ever failed to pay either your premium and/or any excess?
8) Have you or any prior practice ever been refused professional indemnity insurance
or had such insurance cancelled?
9) Has there been any significant changes to or in the Practice in the last 12 months or
do you expect any significant change during the next 12 months
10) Are there any areas of the Practice that need further explanation (e.g. a niche field of work)
If Yes to questions 6-10 above, please provide details on a separate sheet.
Part 8 - Claims & Circumstances
Part 9 - Current Premium
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
5
Part 10 - Area of Practice
1. Has your practice or any prior practices ever undertaken any financial services work?
If Yes, has this always been introductory only to a third party provider?
2. Has your firm undertaken work in relation to selling or advising on any mortgage endowment
policies in 1990 or any subsequent years?
3. Please indicate the percentage of your gross fees (to the nearest whole percent) allocated to the areas below for the last three
financial years. (For guidance see definitions at the back of this form).
YES NO
YES NO
YES NO
4. Has the practice or any prior practice ever carried out any Conveyancing work?
If No, please proceed to Part 11
If Yes, please complete the attached Conveyancing Questionnaire and answer the following:
Please provide details of: Residential Commercial
The highest value in the last 12 months?
The average value in the last 12 months?
Has the Firm been granted accreditation under the Law Society’s Conveyancing Quality Scheme?
If Yes, please state date first granted
Has your Firm been asked by a lender to agree to more onerous terms and conditions
than provided for in the CML Handbook
1. Administering oaths, taking affidavits
and notary public
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
100%Total
2. Agency Advocacy
21. Marine Law – litigious
22. Matrimonial/Family
3. Acting as an Arbitrator, Adjudicator or Mediator
23. Non-litigious work other than given in any
other category (Please provide details)
4. Children, Mental Health Tribunal and Welfare
24. Offices and Appointments
5. Commercial Litigation
25. Parliamentary Agency
6. Commercial/Corporate Work (excluding work
relating to Public Companies)
26. Personal Injury – Claimant
7. Conveyancing – Commercial
27. Personal Injury – Defendant
8. Conveyancing – Residential
28. Probate and Estate Administration
9. Criminal Law
29. Property Selling, Valuations and
Property Management
10. Debt collection (low risk not exceeding
£10,000)
30. Town and Country Planning
11. Debt collection (high risk other than
detailed above)
If you indicate a percentage in any of the areas below, please provide
full details on a separate sheet
12. Defendant Litigation (Insurers)
31. Commercial/Corporate Work for
Public Companies
13. Employment (contentious)
32. EC Competition Law and Human Rights Law
14. Employment (non-contentious)
33. Intellectual Property Work: including patent
trademark or copyright
15. Financial Advice and Services
regulated by the SRA
34. Wills, Trusts and Tax Planning
16. Immigration
35. E-commerce and/or
Information Technology Work
17. Landlord and Tenant (Non-Litigious)
36. Mergers and Acquisitions including
Management Buy-outs and Buy-ins
18. Landlord and Tenant (Litigious)
37. Financial Advice and Services where your
practice has opted into regulation by the
Financial Conduct Authority
19. Lecturing and Related Activities
and Expert Witness work
20. Litigious work other than given in any
other category (Please provide details)
YES NO
YES NO
YES NO
£
£
£
£
6
Part 11 - Commercial Work
Part 12 - Litigation Work
Have you undertaken any litigation in the last three financial years?
If “No” please proceed to Part 13
i) In the last six years has your Practice, or any prior Practice, accepted instructions for any
group litigation and/or class actions or other group litigation, where you have acted for either
the Defendant or Claimant:
If Yes, please provide full details on a separate sheet
ii) Over the last three financial years, what was the average size of settlement awarded?
iii) What was the largest settlement achieved in the last three years?
iv) What percentage of all litigation settlements in the last financial year were less than £50,000?
Have you undertaken any Commercial Work in the last three financial years?
If No, then please go to Part 12 -
In respect of Commercial work, please provide Gross Fee Income for the last accounting period from:
YES NO
Area
Area of Work Contract Value
£
£
£
£
£
£
£ £
£ £
£ £
£
£
£
£
£
£
£
£
£
Fees earned Year completed
Public or non-public company.
Please state.
Area
Gross fees
non-public
companies
Gross fees
non-public
companies
Gross fees
public
companies
Gross fees
public
companies
Mergers and acquisitions
Debt issuance/
securitisation
Project financing
Pension schemes
Tax
Insolvency
Regulation/compliance
Other (please specify)
Other (please specify)
Other (please specify)
YES NO
YES NO
Please list the three largest matters over the last three years and fees earned in each case:
£
£
%
7
Have you undertaken any personal injury work in the last three financial years?
If No, please go to Part 14.
a. What was your average and largest personal injury claimant settlement
during the last financial year?
Average (£) Largest (£)
b. Please estimate the number of personal injury cases you currently have where the expected
settlement exceeds £250,000.
c. Approximately how many claimant personal injury cases has the Practice dealt with
during the last 12 months?
d. What percentage of your current cases have ATE insurance?
e. What percentage of your work is Trade Union funded?
f. Please advise your claimant personal injury work by percentage:
h. Do you receive or have you received in the last three years any commission or other
financial incentive from any insurer or expert report provider?
If Yes, please provide full details on a separate sheet
Please confirm the total fees outstanding to your practice as at the date of this application.
What percentage of this amount was billed more than 90 days ago?
What is the total unbilled work in progress as at the date of this application?
Does the firm currently have an overdraft facility?
If Yes, what is the balance owing as at the date of this application?
Does the firm have any loans or other borrowing from a third party?
If Yes, what is the amount owing and for what purpose were the funds raised?
Has the firm given any undertaking or guarantees in respect of professional practice loans to
principals acquiring an interest in the firm?
8
Part 13 - Personal Injury Work
Part 14 - Financial Accounts
YES NO
YES NO
YES NO
YES NO
YES NO
£
£
%
£
£
£
%
%
%
%
%%%%%
£
Insurer name Percentage
Clinical
Negligence
Class
Action
Road Traffic
Accident
Employers/
Public Liability
Occupational
Disease
Other
g. Please provide details of any ATE insurance provider (specifying the percentage in each case) that you place more than
20% of your business
Please choose the limit of liability and excess required.
(Please note: Minimum limit of indemnity is £2m and £3m for an incorporated practice).
Part 15 - Limit of Liability & Excess
Part 16 - Material Information
Part 17 - Risk Management Section
££
££
ExcessExcess
££
££
Sum InsuredSum Insured
Is there any other material information that may be relevant to this form?
If yes, please explain on a separate sheet.
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
a. Is the Practice LEXCEL accredited?
If Yes, please provide accreditation date and proceed to “confirmation section”
b. Which other Legal Services Commission Quality Marks or other quality standards, e.g. ISO or Investors In People, is your practice
currently accredited with? Please specify and give the date of accreditation.
c. Does the Practice have a risk management strategy?
d. Does the Practice analyse and review complaints and claims record on a regular basis?
e. Does the Practice operate a firm wide diary system?
f. If Yes, does the Practice have a system to ensure all key dates are clearly noted on the file as well as
central diary system?
g. Are regular file audits (at least quarterly) undertaken in each department including Partners’,
Principals’, Members’ or Directors’ files?
h. Is the work (including workloads) of all fee-earners supervised by a Partner(s), Principal(s), Member(s)
or Director(s)?
i. Are all relevant telephone conversations or verbal advices recorded on the file?
j. Does the Practice have a formal conflict search procedure in place when opening new files?
k. Before accepting new instructions, are all new clients vetted and agreed by a Partner, Principal,
Member, Director or Head of Department?
l. Does the Practice provide regular written costs updates to the client during the progress of the file?
m. Does the Practice have policies in place to ensure all staff are up to date with legal developments?
n. Does the Practice have an anti-money laundering procedure and if so are all staff provided with
requisite training?
o. Do all cheques over £25,000 require two partner’s signatures?
p. Is there any dual control over electronic funds transfer so that no one person can transfer money
without the knowledge of the other?
If No is answered to any of the questions c-p, please provide full details on a separate sheet
9
All personal data collected by Legal Ex Plus(LEX) will be held in accordance with the Data Protection Act 1998. LEX will disclose
this information to our service providers and agents for administration purposes and for underwriting and claims handling
purposes. In addition LEX may exchange information with other organisations such as the police, regulatory authorities and
professional bodies by whose rules we are bound, through various databases to help us check information provided and to prevent
fraud. By returning this form, you consent to the processing of personal data, including sensitive personal data, for these purposes
and to LEX transferring such information outside the European Economic Area where necessary.
When you provide information about another person, you are confirming that they have appointed you to act for them. Such persons
will have been made aware of the purposes for the data collection and processing set out above and have consented to such
processing. You will receive on their behalf any data protection notices and keep them informed about how their data will be
processed and where it may be disclosed.
LEX may share personal data with other companies with which we establish commercial links so we and they may contact you (by
mail, email, telephone or other appropriate means) in order to keep you informed about carefully selected products, services or
offers that we believe will be of interest to you. If you do not wish us to do this please tick the box.
I declare that to the best of my knowledge or belief the particulars and statements given in this application and any other
documentation and information provided in connection with this application are true and complete and this application,
declaration, documentation and information will be the basis of the contract between my practice and the insurer.
I declare that I have informed the insurer of all the facts which are likely to influence an insurer in the acceptance or assessment of
this insurance. I understand that the failure to do so could invalidate the insurance accepted by my practice. I accept that if I am in
doubt whether any fact may influence an insurer I should disclose it.
I accept that all data collected by LEX will be held in accordance with the Data Protection Act 1998 and that LEX may disclose this
information only in order to obtain quotations for my/our practice’s professional indemnity insurance.
Signing this form does not bind you to accept any quotation provided by Legal Ex Plus.
Signature (principal/member) Date:
Print Name (principal/member)
Have you fully signed and dated the form and answered all questions? Please provide a piece of your
headed notepaper marked “specimen”.
If you have any notified claims or circumstances please provide a claims print from either the
Qualifying Insurer insuring you at the time the circumstance/claim was first notified.
Copies of all reports and determinations issued by any Disciplinary Tribunal or any regulatory body.
If you are a new practice please provide Curriculum Vitae for every principal/member,
a Business Plan and a Cash Flow Statement.
If you are an LLP, please provide a copy of your most recent statutory/management accounts.
How many additional sheets are there with this proposal form?
PLEASE RETURN THIS FORM TO:
Legal Ex Plus
Great Northern House
275 Deansgate
Manchester
M3 4EL
Email: info@legalexplus.com
Confirmation
Submission Checklist
YES NO
YES NO
YES NO
YES NO
YES NO
10
LEGAL EX PLUS is a trading style of Lex Insure Services Limited (FCA No. 776004). Lex Insure Services Limited is an appointed
representative of Independent Connections which is authorised and regulated by the Financial Conduct Authority and is entered in the
Financial Services Authority Register with registered number 547989.The Financial Services Authority's Register can be accessed at
http://www.fsa.gov.uk/register or by contacting the Financial Conduct Authority on 0800 111 6768.
Registered Office: Atria House, Spa Road, Bolton, BL1 4AG
This form is to be read in conjunction with the application and
policy documentation.
Area of practice
Agency advocacy
Defined as all advocacy work, including attendance at a Court
or Tribunal for the purpose of such advocacy, done on behalf
of another insured practice.
Commercial/corporate work – excluding work related to
public companies
This covers all commercial and private company work
including mergers and acquisitions, corporate trusts and
taxation.
Commercial/corporate work for public companies
This covers all work relating to public limited companies
including mergers and acquisitions, corporate trusts and
taxation. If you have indicated a percentage in this area,
please provide full details on a separate sheet.
Conveyancing – Commercial
Acting on the acquisition, sale or financing of freehold or
leasehold property where the client is acting in the course of
a business.
Conveyancing – Residential
Acting on the acquisition, sale or financing of freehold or
leasehold property where the client is not acting in the course
of a business.
Employment - Contentious
Advising and acting on disputes between employer and
employee which arise from statute and/or contracts of
employment.
Employment - Non Contentious
General employment advice to employers, including corporate
support on transfer of businesses; employee benefits and
drafting of contracts of employment and staff handbooks.
Financial advice and services regulated by the Solicitors
Regulation Authority
This covers financial advice and services regulated by the
Solicitors Regulation Authority as a designated professional
body under the Financial Services and Markets Act 2000.
Financial advice and services where your firm has opted
into regulation by the Financial Services Authority
This covers financial advice and services directly regulated by
the Financial Services Authority under the Financial Services
and Markets Act 2000. If you have indicated a percentage in
this area, please provide full details on a separate sheet.
Landlord and Tenant
Dealing with the exercise of contractual rights under a lease
whether acting for a landlord or a tenant, including rights of
enfranchisement, Landlord & Tenant Act 1954 claims, rent
reviews, rights to manage, possession, and dilapidations.
Definitions
Lecturing and related activities and Expert Witness work
This includes work involving the preparation for, and the
presentation of, lectures, seminars, training and tuition
whether for the purposes of professional skills training,
continuing education or otherwise, and including the provision
of written material for publication.
Offices and appointments
As clerks to City Livery Companies, Dean and Chapters,
Drainage Boards, Local Councils, Charities or School Governing
Bodies; Diocesan Registrars, Archdeacon's Registrars or
Provincial Registrars of the Provinces of the Church of England
in respect of work covered by an Ecclesiastical Fees Order,
provided that any such offices and appointments are
undertaken in the course of private legal practice.
THIS DOES NOT INCLUDE APPOINTMENT AS AN OFFICER OR
DIRECTOR OF A COMPANY.
Parliamentary agency
Defined as all work done in the promotion of or opposition to
primary or subordinate legislation.
Property selling, valuation and property management
This covers property selling, valuations and property
management carried out by the practice but does not include
any separate business providing these services that is outside
the regulation of the Solicitors Regulation Authority.
Succession
Successor practice/prior practice
The definition of successor practice in the Minimum Terms and
Conditions is complicated. You may be a successor practice
even though you did not intend to take on the liabilities of
another practice when taking it over or merging with it and
even if you specifically agreed that those liabilities would
remain elsewhere. Whenever a practice ceases "being carried
on as a discrete business", there is potential for the successor
practice clause to take effect. You may become a successor
practice by holding out your practice "expressly or by
implication" as being the successor of or by incorporating the
other practice(s), by taking on a majority of the principals in
the other practice as principals in your firm, by taking on at
least one such principal as a principal when the majority have
not become principals in another practice, by taking a sole
practitioner or Recognised Body into your firm as a principal,
or by taking on a sole practitioner as an employee after 31
August 2000. If your firm has done any of these things, at any
time or is planning to do so, you may be a successor practice
and should provide full details.
11
Email to: info@legalexplus.com
For Enquiries Call: 0800 180 4203
Conveyancing Questionnaire
This questionnaire must be completed if at any time Gross Fees for your firm have been derived from any conveyancing work
including remortgages (residential and/or commercial). Continue any explanations on a separate sheet, where necessary.
1. Please state the number of fee earners in your firm who undertake or have undertaken conveyancing work.
2. Please complete the table below in relation to residential conveyancing:
3. Please complete the table below in relation to commercial conveyancing:
4. Estimate what percentage of all your conveyancing instructions in each of the last four complete financial years relates to the
purchase of buy-to-let properties?
5. In any of the last six years has any client or referrer been responsible for more than 5% of your
conveyancing instructions whether or not a formal referral arrangement was in place? e.g. a mortgage
broker, estate agent
If ‘Yes’ please provide full details on a separate sheet
6. Has your practice acted for multiple (three or more) purchasers in the same development
or building in the last 6 years?
If ‘Yes’ please provide details on a separate sheet
7. In respect of right to buy purchases, has your firm or any Prior Practice received referrals from
a broker or claims management company in the last 15 years?
YES NO
YES NO
YES NO
Last Completed Year
Last Completed Year Prior Completed Year - 1 Prior Completed Year - 2 Prior Completed Year - 3
Last Completed Year
Last Completed Year
Gross Fees
Gross Fees
Number of
Transactions
Number of
Transactions
Highest Capital
Value
Highest Capital
Value
Principals
Average Typical
Capital Value
Average Typical
Capital Value
Other qualified
fee earners
Percentage of Transactions
relating to remortgage work
Percentage of Transactions
relating to remortgage work
Non qualified fee earners
Prior Completed Year - 1
Prior Completed Year - 1
Prior Completed Year - 1
Prior Completed Year - 2
Prior Completed Year - 2
Prior Completed Year - 2
Prior Completed Year - 3
Prior Completed Year - 3
Prior Completed Year - 3
LEGAL EX PLUS is a trading style of Lex Insure Services Limited (FCA No. 776004). Lex Insure Services Limited is an appointed
representative of Independent Connections which is authorised and regulated by the Financial Conduct Authority and is entered in the
Financial Services Authority Register with registered number 547989.The Financial Services Authority's Register can be accessed at
http://www.fsa.gov.uk/register or by contacting the Financial Conduct Authority on 0800 111 6768.
Registered Office: Atria House, Spa Road, Bolton, BL1 4AG
12
Email to: info@legalexplus.com
For Enquiries Call: 0800 180 4203
8. Please complete the table below in relation to right to buy transactions:
9. Please confirm if the Practice has the following:
a) The Practice has procedures in place in order to avoid mortgage fraud (including regular training)?
b) The Practice has procedures in place for reporting matters of concern to lender clients?
c) Within the last 6 years provided advice on or acted in a transaction involving the SDLT scheme?
d) Within the last 6 years performed residential/commercial estate agency?
e) Within the last 6 years performed surveys/valuations for lenders or financial institutions?
f) Within the last 6 years produced home buyers/condition reports?
g) In the last 6 years produced a home information pack other than for the vendor you are acting for?
If “Yes” to any question c) to g) please provide full details on a separate sheet
10. On approximately how many occasions in the last 3 years have you received requests for conveyancing files from lenders? Please
provide full details including the name(s) of the lender(s) and the total number of individual files requested, and confirmation
that the then insurer was notified.
11. Have you ever been suspended or removed from any lender panel?
If ‘Yes’ please provide full details including the name(s) of the lender(s) on a separate sheet.
12. Over the last five years what processes has the Practice put in place to ensure that changes to lender requirements are
appropriately tracked? If there has been a material change in your procedures and/or you have deployed new software please
provide dates of implementation
13. Does anyone other than a Principal sign reports and/or certificates of title addressed to lenders
or their representatives? If ‘Yes’ please provide full details on a separate sheet.
14. Has the Firm or any Prior Practice acted in the last five years in any conveyancing transaction involving
a subprime lender?
15. Has the Practice (or any Prior Practice) ever:
a) advised on Equity Release Plans?
b) accepted instructions from property clubs or investment schemes?
c) does the practice plan to do any of the above in the next 12 months?
If ‘Yes’ please provide details on a separate sheet
Signed (Principal/Partner/Member/Director): Date:
Last Completed Year
Gross Fees
Number of
Transactions
Highest Capital
Value
Average Typical
Capital Value
Percentage of Transactions
relating to remortgage work
Prior Completed Year - 1
Prior Completed Year - 2
Prior Completed Year - 3
YES NO Number
YES NO Number
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
LEGAL EX PLUS is a trading style of Lex Insure Services Limited (FCA No. 776004). Lex Insure Services Limited is an appointed
representative of Independent Connections which is authorised and regulated by the Financial Conduct Authority and is entered in the
Financial Services Authority Register with registered number 547989.The Financial Services Authority's Register can be accessed at
http://www.fsa.gov.uk/register or by contacting the Financial Conduct Authority on 0800 111 6768.
Registered Office: Atria House, Spa Road, Bolton, BL1 4AG
13
Additional Information
14
Please use this space to provide further information in support of answers given to questions in the proposal form.
Please state the question numbers clearly.
15
Additional Information
Please use this space to provide further information in support of answers given to questions in the proposal form.
Please state the question numbers clearly.
Legal Ex Plus
Great Northern House
275 Deansgate
Manchester
M3 4EL
Email: info@legalexplus.com
For Enquiries Call: 0800 180 4203
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LegalEx-PII-Prop-Form-2017 Final M004-18

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Completed 1 October 2019

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