Royal & Sun Alliance Insurance plc (No. 93792).
Registered in England and Wales at St Mark’s Court,
Chart Way, Horsham, West Sussex RH12 1XL.
Authorised by the Prudential Regulation Authority and regulated by the
Financial Conduct Authority and the Prudential Regulation Authority.
UKC02101D PI IT Professionals January 2019
Please read the following carefully before you sign and date the Declaration And Undertaking.
IMPORTANT NOTICE CONCERNING YOUR DUTY TO MAKE A FAIR PRESENTATION OF THE RISK
Before the insurance policy takes effect the Insured have a duty to make a fair presentation of the risks to be insured under
the insurance policy.
A fair presentation of the risk is one:
– discloses to the Insurer every material circumstance which you know of or ought to know of; or
– gives the Insurer sufﬁcient information to put the Insurer on notice that it will need to make further enquiries for the
purpose of revealing those material circumstances,
• which makes that disclosure referred to above in a manner which is reasonably clear and accessible to the Insurer; and
• in which every material representation as to a matter of fact is substantially correct, and every material representation as to
a matter of expectation or belief is made in good faith.
A material circumstance is one that would inﬂuence the Insurer’s decision as to whether or not to agree to insure you and, if so,
the terms of that insurance. If you are in any doubt as to whether a circumstance is material you should disclose it to the Insurer.
A copy of the proposal should be retained by you for your own records.
FINANCIAL OR TRADE SANCTIONS
Royal & Sun Alliance Insurance plc is unable to provide insurance in circumstances where to do so would be in breach of any
ﬁnancial or trade sanctions imposed by the United Nations or any government, governmental or judicial body or regulatory agency.
RSA is committed to ensuring that your privacy is protected.
For a full explanation of how we use the information we collect about you, how you can contact us if you wish
to exercise your rights and the procedure that we have in place to safeguard your privacy please visit:
DECLARATION AND UNDERTAKING
I/We declare that every statement and particular contained within this proposal form:
• which is a statement of fact, is substantially correct, and
• which is matter of expectation or belief, is made in good faith.
If any such facts, expectations and/or beliefs materially change before the insurance policy takes effect I/we undertake to provide
details of all such changes to the Insurer in order to comply with my/our obligation to provide a fair presentation of the risk to be
insured under the insurance policy.
For the purposes of making this proposal for insurance, I/we agree that the Intermediary (which I/we have appointed to advise in
relation to this policy) is acting on my/our behalf and not as an agent of the Insurer.
On behalf of*
*insert name of ﬁrm
This insurance will not commence until the Insurer has indicated acceptance of the Proposal. The Insurer reserves the right to
decline any Proposal.
click to sign
click to edit