• Conveyancer’s Management Liability Insurance Proposal Form

    • Applicant Details 
    • Please select your entity type
    • Would you like to include an additional business address?*
    • Format: 0000000000.
    • Detail of Business 
    • Staff numbers
      Rows
    • Please provide the total income for each financial year*
      Rows
    • Do you expect to be the subject of a Tax Audit or Review by a government department over the next 12 months?*
    • Management Liability 
    • Please indicate the level of indemnity required.
    • Claims History 
    • In the last 5 years have there been any claims made against the company or its directors or employees which may have been covered under this policy if it were in force?*
    • In the last 5 years has the company suffered any direct financial loss exceeding $5,000 as a result of fraud or dishonesty committed by a staff member?*
    • Has any director or officer of the company ever had proceedings (civil or criminal) instigated against them alleging misconduct or breaches of the law in their capacity as a director or officer of a company?*
    • Are any of the directors or employees aware of: a. Any facts which might give rise to a claim being made against the company or its directors or employees which may be covered under this policy if it commences. b. Any facts which would cause a reasonable person to think that the company might suffer a direct financial loss as a result of fraud or dishonesty committed by a staff member.*
    • Declaration 
    • SIGNING THIS PROPOSAL FORM DOES NOT BIND THE PROPOSER OR THE INSURER TO COMPLETE THIS INSURANCE.

      The undersigned declares that the statement and particulars in this proposal form are true and that no material facts have been misstated or suppressed after enquiry. The undersigned agree that should any of the information given by us alter between the date of this proposal and the inception date of the insurance to which this proposal relates, the undersigned will give immediate notice thereof. The undersigned agrees that the Underwriters may use and disclose your personal information in accordance with the “Privacy Statement” at the beginning of this Proposal. The undersigned agrees that this proposal, together with any other information supplied by us shall form the basis of any contract of insurance effected thereon.

      TO BE SIGNED BY THE INSURED FOR WHOM THIS INSURANCE IS INTENDED FOR.

    • Date*
       - -
      2 digit day, 2 digit month, 4 digit year
    • Important Information
       
      Duty of Disclosure

      For general insurance contracts that are not Consumer Insurance Contracts, then Before you enter into an insurance contract, you have a duty of disclosure under the Insurance Contracts Act 1984 (Cth) to tell us anything that you know, or could reasonably be expected to know, may affect the insurer’s decision to insure you and on what terms. You have this duty until the contract of insurance is entered into. You have the same duty before you renew, extend, vary or reinstate an insurance contract.
      If we ask you questions that are relevant to the insurer’s decision to insure you and on what terms, you must tell us anything that you know and that a reasonable person in the circumstances would include in answering the questions. Also, we may give you a copy of anything you have previously told us and ask you to tell us if it has changed. If we do this, you must tell us about any change or tell us that there is no change. If you do not tell us about a change to something you have previously told us, you will be taken to have told us that there is no change.
      You do not need to tell us anything that: reduces the risk insured, or is common knowledge, or the insurer knows or should know as an insurer; or the insurer waives your duty to tell them about.
      If you do not tell us something:
      If you do not tell us anything you are required to, the insurer may cancel your contract or reduce the amount it will pay you if you make a claim, or both. If your failure to tell us is fraudulent, the insurer may refuse to pay a claim and treat the contract as if it never existed.
      If you are in any doubt as to the extent of the duty of disclosure or whether a piece of information ought to be disclosed, just contact your Marsh Client Risk Adviser.

       
      Changes of Risk
       
      You must tell us and the insurer immediately if there is a material change in the risk(s) insured under your relevant insurance policy, or otherwise any material changes to your business which may have a bearing on your insurance (for example, any mergers or acquisitions, changes in occupation or location, new products or services, or new overseas activities). If you are in doubt as to whether there has been a material change, please contact us. 
       
      Claims Made
       
      Please note that some policies (for example, professional indemnity insurance) provide cover on a ‘claims made’ basis. 
       
      This Policy operates on a ‘claims made and notified’ basis. This means that the Policy covers you for claims made against you and notified to us during the period of insurance.
      The Policy does not provide cover in relation to:
      1. acts, errors or omissions actually or allegedly committed prior to the retroactive date of the Policy (if such a date is specified);
      2. claims made after the expiry of the period of insurance even though the event giving rise to the claim may have occurred during the period of insurance;
      3. claims notified or arising out of facts or circumstances notified (or which ought reasonably to have been notified) under any previous policy;
      4. claims made, threatened or intimated against you prior to the commencement of the period of insurance;
      5. facts or circumstances of which you first became aware prior to the period of insurance, and which you knew or ought reasonably to have known had the potential to give rise to a claim under this Policy; and
      6. claims arising out of circumstances noted on the proposal form for the current period of insurance or on any previous proposal form.
      Where you give notice in writing to us of any facts that might give rise to a claim against you as soon as reasonably practical after you become aware of those facts but before the expiry of the period of insurance, you may have rights under section 40(3) of the Insurance Contracts Act 1984 (Cth) to be indemnified in respect of any claim subsequently made against you arising from those facts notwithstanding that the claim is made after the expiry of the period of insurance. Any such rights arise under the legislation only. The terms of the Policy and the effect of the Policy is that you are not covered for claims made against you after the expiry of the period of insurance.
       
      Marsh Collection Statement
       
      In accordance with the Privacy Act 1988 (Cth) (and subsequent amendments) (‘the Privacy Act’), we, Marsh Pty Ltd and our Associated Entities (as that term is defined in the Corporations Act 2001 (Cth)) (‘Marsh’) draw your attention to the following:
      • We may collect personal information about you by means of the enclosed document.
      • We are collecting the information principally for the purpose of approaching the (re)insurance market, placing insurance, assessing and advising you on your insurance needs, claims handling or risk management (depending on your requirements). Other purposes include providing you with information about other Marsh products or services and administering payments to you. If you are proposing for or renewing insurance, the information is required pursuant to your duty of disclosure under the Insurance Contracts Act 1984 (Cth), the Marine Insurance Act 1909 (Cth) or at common law.
      • The information we collect may be disclosed to third parties including but not limited to (re)insurers, insurance intermediaries, service providers, finance providers, advisers, agents and Marsh’s Associated Entities, which are all businesses of Marsh & McLennan group of companies (‘MMC’).
      • Your personal information may be sent to our administrative processing centres in Mumbai (India) or Kuala Lumpur (Malaysia) and to other MMC companies, insurers, reinsurers and other third party service providers (e.g. data storage providers) in the United Kingdom, Singapore, Hong Kong, the United States of America and elsewhere.
      • If you provide us with personal information about other individuals, you must ensure that those persons have been made aware of the above matters. Where the information collected relates to health, criminal record or other sensitive information as defined in the Privacy Act, you must obtain it with the individual’s consent.
      • We will use and disclose your personal information in accordance with our Privacy Policy. By completing this form you confirm that you have read the Marsh Privacy Policy available on our website (www.marsh.com.au) and you authorise and consent to Marsh collecting, holding, using and disclosing any personal information collected by means of the enclosed document in accordance with the terms of the Marsh Privacy Policy, including for the purposes explained in this collection statement above. If there are any inconsistencies between the terms of this collection statement and the terms of the Marsh Privacy Policy, the terms of the Marsh Privacy Policy prevail to the extent of that inconsistency. You may modify or withdraw your consent at any time. If you do not give us consent or subsequently modify or withdraw your consent, we may not be able to provide you with the products or services you want.
      • You can contact our Privacy Officer by:
      Email – privacy.australia@marsh.com

      Phone – (02) 8864 7688
      Post – PO Box H176, Australia Square NSW 1215

    • Marsh Pty Ltd (ABN 86 004 651 512), Australian Financial Services Licence (AFSL) No. 238983 (“Marsh”) arranges the insurance and is not the insurer.

      This form contains general information and does not take into account your individual objectives, financial situation or needs. For full details of the terms, conditions and limitations of the covers, refer to the specific policy wordings and/or Product Disclosure Statements available from Marsh on request. Marsh makes no representation or warranty concerning the application of policy wordings or the financial condition or solvency of insurers or re-insurers. Marsh makes no assurances regarding the availability, cost, or terms of insurance coverage. Any statements concerning actuarial, tax, accounting, or legal matters are based solely on our experience as insurance brokers and risk consultants and are not to be relied upon as actuarial, accounting, tax, or legal advice, for which you should consult your own professional advisors.

       

      Copyright © 2026 Marsh. All rights reserved.

    • Should be Empty: