1. ADVICE ON COMPLETING THE PROPOSAL FORMweb-resources.hyperiongrp.com/.../solicitors-pi-proposal-form-aug-20… · 2.2 If you are the successor practice to a Firm which has purchased

1. ADVICE ON COMPLETING THE PROPOSAL FORM TO ALLOW US SUFFICIENT TIME TO NEGOTIATE WITH INSURERS, PLEASE ENSURE YOU RETURN THIS PROPOSAL FORM AS SOON AS POSSIBLE. IT IS ESSENTIAL THAT YOU ALLOW SUFFICIENT TIME TO COMPLETE THE PROPOSAL FORM AND PROVIDE ACCURATE INFORMATION. INSURERS REGARD THE PROPOSAL FORM AS A REFLECTION OF THE QUALITY OF THE BUSINESS SEEKING INSURANCE; A POORLY COMPLETED, UNTIDY OR INACCURATE FORM CAN REFLECT BADLY ON A BUSINESS AND WILL NOT ASSIST US IN SECURING TERMS.

Page 1

2016 PROPOSAL FORM

1.1 DEFINITIONS OF TERMS USED IN THIS PROPOSAL FORM Senior Management' means, in accordance with the Insurance Act 2015: those individuals who play significant roles inthe making of decisions about how the insured's activities are to be managed or organised. Under Section 4 of the Insurance Act 2015 an Insured must disclose all material circumstances known to its `senior management' and thosepersons responsible for the Insured's insurance. Please see Section 12 in this proposal form. Please refer to the further definitions at the back of this document prior to completion. 1.2 DUTY OF FAIR PRESENTATION Under English law, you owe a duty of disclosure to the insurer which includes your duty to make a fair presentation of the risk. A 'fair presentation' is one:

• which clearly discloses all material circumstances which the insured's Senior Management, including persons responsible for the insured's insurance, know or ought to know following a reasonable search or which is sufficient to make the insurer ask questions about the risk. A circumstance is material if it would influence an insurer's judgment in determining whether to take the risk and, if so, on what terms. If you are in any doubt whether a circumstance is material we recommend that it should be disclosed;

• which discloses information in a manner which is clear and accessible to a prudent insurer (i.e. no `data dumping');

• 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.

Failure to disclose a material circumstance may entitle an insurer to:

• in some circumstances, avoid the policy from inception and in this event any claims under the policy would not be paid;

• impose different terms on your cover; and/or • proportionately reduce the amount of any claim payable.

This duty applies:

• before your cover is placed; • when it is renewed; and • at any time that it is varied.

Your policy wording may also provide that this duty continues for the duration of the policy.

You should contact us immediately for assistance if you are unsure whether information may be material, or if it comes to your attention that you may have not disclosed full and accurate information.

2016 PROPOSAL FORM

Page 2

1.3 GENERAL INSTRUCTIONS RELATING TO COMPLETION OF THE FORM

• Please ensure this proposal form is completed by a Principal of the business. • A response to all questions must be entered. Where a question is not relevant to your business, please respond

N/A rather than leave blank. • If the proposal form is completed by just one of the Principals, please ensure that full consultation is made with

the Senior Management, prior to submission of this form and that they, in turn, have consulted those for whom they are responsible.

• If you are completing this Proposal Form by hand, it should be completed in black ink and preferably in block capitals.

• If there is insufficient space to answer any questions please provide full details on your headed paper. Please ensure that any additional information is signed, dated and makes clear reference to the question(s) on the Proposal Form, to which it refers.

• Completion of this proposal form does not automatically bind the Principal, the Firm or Insurers to effect a contract of insurance.

• A copy of this proposal should be retained for your own records. • We would remind you that this type of policy is written on a “claims made” basis and it is extremely important

to deal promptly with the provision of the required information in good time prior to inception/renewal date.

1.4 PROVIDING ADDITIONAL INFORMATION

If you feel there is additional information required in order to make a fair presentation of the risk which is not requested by this form, such information should be set out clearly and attached to this proposal form. Additional information, where not requested by the proposal form, could include: • Corporate brochure(s); • Organisation chart(s); • An overview of risk management; • CV's of the Principal(s); • A description of any services provided in the past 6 years which are no longer provided and/or any new services

the business intends to provide in the future; • An overview of the client base; • Standard Terms of Engagement. 1.5 CLAIMS AND CIRCUMSTANCES

Whilst every question on the proposal form is important and constitutes material information upon which Insurers rely, Insurers will be particularly interested in your history of claims and/or circumstances. In order to ensure that all notifiable matters are declared, the recommended practice would be for each Principal including all members of the Senior Management and other senior members of staff to sign a declaration to the effect that he/she has investigated the areas for which he/she is responsible and can confirm that there are no claims or circumstances other than those declared in the proposal form. After completion of the proposal form and prior to the expiry of the firm's current insurance, a check should be undertaken within the Business to ensure that there are no claims or circumstances of which anyone is aware other than those already notified in the proposal form. If any new matters are discovered, these should be immediately notified to Howden if we are your current Broker. If weare not your current Broker, then you should notify your current Broker/Insurers and Howden. Such notifications should reach your current Broker/Insurers and Howden prior to the expiry date of the firm's current insurance. If you have any queries please call 0207 133 1276 or email us at [email protected]

mailto:[email protected]?subject=Solicitors%20Proposal%20Form%202015

1.1 Please state all practising titles including associate nominees, alternative business structures and service companies of your Firm and state the type of entity: Sole Practitioner (SP), Partnership (P), Limited Liability Partnership (LLP), Legal Disciplinary Practice (LDP), Alternative Business Structure (ABS), Recognised body (R). Please include all entities for which you are seeking cover, including all discrete SRA IDs using a separate sheet if necessary.

Page 3

2016 PROPOSAL FORM

SECTION 1 - GENERAL DETAILS

Titles Type Postcode Est Date SRA ID

1.2 Principal office address Preferred mailing address (if different)

1.3 Telephone number 1.4 Website address

1.5 Email address (of Professional Indemnity contact)

1.6 If there are any overseas domiciled interests to be insured under this Policy please tick this box and give full details on your headed paper.

1.7 If you have any offices in addition to the address in 1.2 above, please tick this box and give full addresses on your headed paper together with the name(s) of resident partner(s). If no resident partner, please describe how the office is supervised.

Page 4

2016 PROPOSAL FORM

SECTION 2 - PRIOR PRACTICE

2.1 Please refer to the successor practice notes at the end of this form for guidance. If you have ever become the successor practice to any prior practice, please tick this box and complete the following details.

Practice name Est Date Succession Date SRA ID

2.2 If you are the successor practice to a Firm which has purchased run-off cover, please tick this box and provide full details on your letter headed paper.

2.3 If you are intending (either specifically or in principle) to expand in the next 12 months by acquisition, please tick this box and give details on your letter headed paper.

SECTION 3 - SOLICITORS AND STAFF

Solicitor Principals

3.1 Please enter number of staff members for each of the following categories:

Non-Solicitor Principals

Solicitor Employees

Other Fee-Earners

No3.2 Do all Principals (whether Solicitors or otherwise) work full-time for the Firm, where this is understood to mean that each is engaged in conducting the Firm's business from the office addresses stated above for at least 30 hours each week? If NO, please provide full details, on a separate sheet, of working arrangements in place and how supervisory responsibilities are discharged.

Yes

NoYes3.3 Did any Principal obtain their first legal qualification outside of England and Wales? If YES, please provide an up-to-date professional CV for all such individuals.

NoYes3.4 Is any Principal, Solicitor or employee in the Firm involved in any way in any other business undertaking or solicitors' practice? If YES, please provide details on a separate sheet.

NoYes3.5 Does the Firm have formal procedures for verifying qualifications including the taking up of references and details of previous claims record?

NoYes3.6 Have there been any changes in the Firm's Partners/Members/Directors since the last time you completed a proposal form? If so, please provide details on a separate sheet, as well as Professional CVs for the new Partners.

Total Number of Employees

Page 5

2016 PROPOSAL FORM

SECTION 4 - FEES & FINANCIAL INFORMATION

Period Year end date DD/MM/YY

UK USA/Cananda Rest of world Total

Estimated current year

Last completed year

Prior Year1 to last completed




4.1 Please provide your gross fee income in GBP for the current financial year (estimated) and the previous five accounting periods. Fees should represent clients domiciled in the specified areas and include Prior Practices.

4.2 If the largest cumulative fee charged to a single client or connected group of clients has exceeded 20% of your annual fee income over any of the last three years, please tick this box and give full details on your letter headed paper.

SECTION 5 - BUSINESS ACTIVITY

5.1 Please provide the gross fee percentage breakdown for the last accounting period in the categories below:

Activity Percentage Activity Percentage

Agency Advocacy Corporate M&A / MBO

Arbitration, Adjudication, Mediation Other General Commercial

Asset Finance & Banking Conveyancing (Commercial) (1)

Children, Family and Mental Health Tribunal Conveyancing (Residential) (1)

Commercial & Corporate - Public Companies Criminal law

Commercial & Corporate - Exc Public Companies Debt Collection

...continued overleaf

4.3 During the last 3 complete financial years, did the Firm incur a pre-tax loss, did its total liabilities exceed its total assets or did you engage in discussions with the Solicitors Regulation Authority regarding concerns about the financial stability of your Firm?

Yes No

Page 6

2016 PROPOSAL FORM

Activity Percentage Activity Percentage

Defendant Litigious work for Insurers Matrimonial

EC Competition / Human Rights Marine Law

E-commerce / Technology Law Oaths, Affidavits and Notary Public

Employment Law Offices and appointments

Environmental Other work not included above (3)

Financial Advice and Services (1) (2) Parliamentary Agency

Immigration Personal Injury - Defendant (1)

Insolvency Personal Injury - Claimant Portal (1)

Intellectual Property - Patent (1) Personal Injury - Claimant Non-Portal (1)

Intellectual Property - Excluding Patent (1) Property Sales, Management and Valuation

Landlord & Tenant - Litigious Regulatory

Landlord & Tenant - Non litigious Tax law & Tax Planning

Lecturing / Expert Witness Town and Country Planning

Litigation not shown elsewhere Trust, Wills and Probate

TOTAL (must total 100%)

(1) If 0% in the current year but you have undertaken such work in the past 6 years, please tick this box and give full details on your headed paper.

(2) If any such work is undertaken, please give full details on your headed paper.

(3) Please specify what this constitutes and provide a percentage breakdown. Please note that full details of the activities undertaken should be provided for “Other work not included above”. An overly concise description can often result in a delay to underwriting and a request for further information.

Activity Percentage

2016 PROPOSAL FORM

Page 7

SECTION 6 - INDIVIDUAL WORK TYPES

6.1 Personal Injury and Claimant Litigation

6.1.1 Please provide the following details in respect of the Firm's claimant litigious (including personal injury) work over the past three annual accounting periods.


No. of cases Largest settlement Average settlement

Last completed year

Last completed prior 1


6.1.2 Please advise the proportion of claimant litigious (including personal injury) cases over the past three annual accounting periods which was undertaken on a Conditional Fee Arrangement (CFA) or similar fee basis, or backed by After The Event (ATE) insurance arranged through (or on the basis of a review conducted by) the Firm.


CFA basis ATE backed

Last completed year



NoYes6.1.3 Over the past five years has all work undertaken on a CFA or similar fee basis, or backed by ATE insurance arranged through (or on the basis of a review conducted by) the Firm, been approved by a Principal prior to acceptance? If NO, please provide details on a separate sheet of the risk management and file review procedures in place.

6.1.4 Has the Firm or any Prior Practice ever accepted instructions in respect of:

NoYesany class actions or other group litigation?

NoYesany industrial or occupational disease claim?

NoYesany medical malpractice claim?

If YES to any of the above, please provide details of the matter and any specific risk management steps taken, on a separate sheet.

6.1.5 Has the Firm or any Prior Practice ever:

NoYesconducted work for or on behalf of a Trade Union or similar body?

NoYesundertaken any work referred by and/or purchased from any claims management company, referral network, or promotional group?

NoYesacted as a panel solicitor reviewing cases on behalf of any ATE insurer?

2016 PROPOSAL FORM

Page 8

NoYesconducted cases backed by ATE insurance where each case was not individually reviewed by the ATE insurer prior to acceptance?

NoYesentered into arrangements to facilitate deductions of any kind from damages payments?

If YES to any of the above, please provide full details of the work undertaken on a separate sheet, including the names of any referral sources and/or ATE insurers as applicable, and any specific risk management steps taken.

6.2.1 Please advise the number of fee-earners in the Firm and/or any Prior Practice who undertake or have undertaken Conveyancing work over the past five annual accounting periods.

6.2 Conveyancing

6.2.2 Please advise which Partner is responsible for supervision and oversight of the conveyancing department.


Solicitors Qualified fee-earners Unqualified fee-earners

Last completed year






Residential Conveyancing Gross Fees

Commercial Conveyancing Gross Fees

Total Conveyancing Fees

Residential Transactions

Commercial Transactions

Total Transactions

Estimate current year

Last completed year





6.2.3 Please provide the following details in respect of all Conveyancing work carried out by the Firm and/or any Prior Practice over the past five annual accounting periods.

2016 PROPOSAL FORM

Page 9

6.2.4 Please provide the following details in respect of all Conveyancing work carried out by the Firm and/or any Prior Practice over the past five annual accounting periods.


Highest Residential Value

Highest Commercial Value

Average Residential Value

Average Commercial Value

% Re-mortgage Transactions

% Buy-to-Let Transactions

Estimate current year

Last completed year





NoYes6.2.5 Has the Firm applied for accreditation under the Law Society's Conveyancing Quality Scheme?

6.2.5.1 Was the application successful? NoYes

6.2.5.2 When is your CQS accreditation due for Renewal?

Accredited from:

6.2.6 Please provide details of your identity verification procedure for Conveyancing clients, including details of the checks carried out and the procedure for checking compliance with lender requirements in this regard.

6.2.7 Over the last five years what safeguards has the Firm (and any Prior Practice) had in place to ensure that features indicative of potential mortgage fraud in Conveyancing transactions (e.g. back-to-back transactions, discounts, incentives) are both identified and reported to lender clients? If there has been a material change in your procedures please provide dates as appropriate.

6.2.8 Over the last five years what processes has the Firm (and any Prior Practice) had in place to ensure that changes to lender requirements (including those under CML Handbook Part 2) are properly tracked? If there has been a material change in your procedures and/or you have deployed software such as Conveycentric Lender Monitor (or similar) please provide details and dates as appropriate.

2016 PROPOSAL FORM

Page 10

6.2.9 What training is and has been provided to fee-earners in the Firm (and any Prior Practice) in respect of identifying potential mortgage fraud and money laundering issues?

NoYesundertaken pure legal work only for Equity release mortgages or Home Income Plans?


NoYesprovided financial advice in respect of Equity Release mortgages or Home Income Plans?

NoYesconducted property valuations for the purpose of lending or probate?

NoYesaccepted instructions from property clubs or investment schemes?

If YES to any of the above, please provide full details on a separate sheet.

NoYesany one client or connected group of clients?

6.2.11 Over any 12-month period in the last five years, have more than 10% of the Firm's Conveyancing instructions (or more than 10% of the Conveyancing instructions accepted by any Prior Practice) originated from:

NoYesany one development (including multiple phases of a single development)?

NoYesany single referral source (whether or not a formal referral arrangement was in place)?

any other known or unknown risk legal indemnity policy?

an All Risks Title Indemnity Policy?

6.2.12 In the last 12 months where acting for the purchaser in residential Conveyancing transactions, how many of your clients have purchased:

NoYes6.2.13 Has the Firm or any Prior Practice acted in the last five years in any Conveyancing transaction involving a sub-prime lender? If YES, please identify the lenders involved and the volume of transactions on your headed paper.

NoYes6.2.14 Has the Firm or any Prior Practice ever been removed or suspended from any lender panel? If YES, please identify the lenders involved and provide full details of the circumstances on your headed paper.

NoYes6.2.15 Are all reports and/or certificates addressed to lenders reviewed and signed by a Principal of the Firm?

2016 PROPOSAL FORM

Page 11

6.3.1 Please provide details of the five largest commercial instructions accepted by the Firm (or any Prior Practice) over the last three annual accounting periods.

6.3 Commercial Work

Area of work Contract value Fees earned Date completed

6.3.2 Please provide details of the Firm's three largest commercial clients by aggregate fee income (including that earned by any Prior Practice) over the last three annual accounting periods.

NoYesprovided advice or services in respect of projects involving oil, gas or other natural resources?

NoYesprovided advice on or services related to marine or aviation law?


If YES, to either of the above, please provide full details of the work undertaken, the client in question, and the relevant qualifications and experience of the solicitors undertaking the work.

Area of work Total fees earned

NoYes

Retainer basis?

NoYes

Yes No

6.4 Has your firm been involved in any setting up or advising on any Tax Mitigation Schemes, including Stamp Duty Land Tax (SDLT) Schemes? If yes, please provide the following details:

6.4.1 Name of Scheme 6.4.2 Date of Scheme

NoYes6.4.3 Did you provide advice?

NoYes6.4.4 Was the scheme execution only?

NoYes6.4.5 Did you receive commission?

NoYes

2016 PROPOSAL FORM

Page 12

SECTION 7 - RISK MANAGEMENT

Accreditation From date

Lexcel

ISO 9001

Specialist Quality Mark

7.1 Is the practice accredited to:

NoYes

NoYes

NoYes

NoYes6.4.6 Was a referral fee paid?

If YES to 6.4.6, please provide the following details.

NoYes6.4.6.1 Is the audit always done by someone independent of the fee earners team?

NoYes6.4.6.2 Do the audit findings get reported to management board?

NoYes6.4.6.3 Do you track remedial action once it has been put in place following audits?

NoYes6.5 Has your firm been involved in any setting up or advising on any Land Banking schemes? If yes, please provide further details on a separate sheet

NoYesa file audit procedure in all departments with regular review by a Principal of all files until formally closed (including other Principals' own casework)?

NoYesa new client procedure which involves at least one qualified solicitor and includes intake checks to detect potential money laundering and conflicts of interest?

7.2 Does the practice have:

NoYesa centralised critical date diary system in operation with procedures in place to deal with staff absence or system failure?

NoYesa system for monitoring live cases which have not been billed or worked upon for a specified period?

NoYesa central log of all complaints/potential claims?

NoYesa subscription to Lexsure's CompletionMonitor case management software? *

* This may make the Firm eligible for a significant premium rebate

7.3 Do you have risk controls in place which mandate that:

NoYes7.3.1 Personnel must never disclose to anyone their security details (passwords, codes, usernames etc) by any means regardless of the apparent authority of the person requesting the details?

Page 13

2016 PROPOSAL FORM

any other known or unknown risk legal indemnity policy?

an Executor and Inheritance Protection Policy?

7.5.1 If you undertake Probate work, on how many occasions in the last 12 months have you advised that the Estate purchase:

7.5.2 Please advise which Partner is responsible for supervision and oversight of the Probate department

SECTION 8 - REGULATION

NoYesever been refused a Practising Certificate by the SRA?

8.1 Has any individual currently employed by the Firm or employed at any time in the last ten years by the Firm or any Prior Practice:

NoYesever been granted a conditional Practising Certificate by the SRA?

If YES, to either of the above, please provide full details and enclose a copy of all relevant correspondence with the SRA. If the individual continues to be employed by the practice, please provide a copy of their current Practising Certificate; if not, please provide details of the circumstances of their departure.

8.2 Has any individual currently employed by the Firm, or employed at any time in the last ten years by the Firm or employed at any time in the last ten years by the Firm or any Prior Practice:

NoYesever been reprimanded, fined or otherwise sanctioned by the Solicitors Disciplinary Tribunal?

NoYes7.5 If you undertake Probate work, do you use “Certainty” to ensure you are executing the final and correct Will and Testament?

NoYes7.3.2 Exchange of bank details for payments to or from the firm must be made at the outset of a transaction, preferably when meeting the client, where the risk of fraud and restrictions on future changes to bank details can be fully explained?

NoYes7.3.3 changes to bank details must not be accepted by remote means (eg by email or telephone), apart from in exceptional circumstances and only when it has been validated that those changes have been made by your client?

NoYes7.3.4 Payments from client account/s must be set up by one person and independently verified/authorised by another against original client bank account name, number and sort-code before funds are transferred?

NoYes7.4 Do you provide training to all staff on the risks of internal and external frauds and scams?

ever been the subject of an investigation by the SRA, or practised in any solicitors' practice which was the subject of an investigation by any other regulatory or professional body?

NoYesever been the subject of, or practised in a business of any nature which was the subject of, an investigation by any other regulatory or professional body (including the FSA/FCA)?

If YES to any of the above, please provide full details and enclose a copy of all reports issued by or relevant correspondence with any regulatory or professional body.

NoYes

2016 PROPOSAL FORM

Page 14

NoYesat any time in the last three years been the subject of a monitoring visit from the SRA?

8.3 Has the Firm or any Prior Practice:

NoYesever been the subject of any visit or enquiry from the Forensic Investigation Unit of the SRA or has notice of any proposed visit been given?

If YES to any of the above, please provide full details including a copy of the report and an explanation of any follow-up actions.

NoYesever been insured through the Assigned Risks Pool?

8.4 Has the Firm, any Prior Practice, or any solicitors' practice of which a Principal in the Firm was a Principal:

NoYesever failed to pay or been late in paying any Professional indemnity premium or premium instalment?

NoYesever failed to pay the excess due under a Professional Indemnity policy?

SECTION 9 - CLAIMS AND CIRCUMSTANCES

9.1 Please provide details of all Claims and Circumstances notified to Participating Insurers or the Assigned Risks Pool by the Firm or any Prior Practice in the past five indemnity periods.

Indemnity period (dd/mm/yy to dd/mm/yy) Participating insurer(s) Broker(s) No. of Claims notified

Please provide an up-to-date Participating Insurer (or Assigned Risks Pool) Claims Summary for each indemnity period specified irrespective of whether claims were notified or not. Summaries should be supplied both for the Firm and for any Prior Practice trading independently during such period. Underwriters will not be able to provide a Firm quotation without these details.*

* Howden are usually able to gather these for you - please ask your Howden contact.

NoYesat any time in the last 5 years self-reported to the SRA in line with the SRA Handbook reporting requirements

9.2 After full enquiry of all Principals, Solicitors and employees in the Firm:

NoYesare you aware of any circumstances, incidents or claims that you have not reported to your current or any prior Professional Indemnity Insurers, or that you have notified but which have not been accepted by insurers as an effective notification?

Please note that you have an obligation under your current Professional Indemnity policy to notify these matters to your current insurer, and that underwriters may require confirmation that you have done so and that the notification has been accepted before a Firm quotation can be provided.

2016 PROPOSAL FORM

Page 15

NoYesare you aware of any circumstances, incidents or claims reported by the Firm or any Prior Practice in the last ten years which have arisen as a result of the dishonesty of any Principal, Solicitor or employee in that practice? If YES, please provide details on a separate sheet.

NoYesare you aware of any circumstances, incidents or claims which have arisen out of the work of any Principal of the Firm in previous employment (or as Principal of another solicitors' practice) during the last five years? If YES, please provide details on a separate sheet.

SECTION 10 - COVER PROFILE (10.1 is optional, please move to Question 10.2 if you are an existing client of Howden)

10.1 Current Cover:

Limit of Indemnity

Policy Excess

Excess Aggregated (aggregate amount) NoYes

Insurer

Broker

Total Premium (excluding IPT)

Alternative excesses

Alternative limits

Excess

Limit

10.2 Cover required for your new policy

Additional Fee (if any)

Policy type Insurer(s) Broker Expiry date

Cyber Liability

Directors & Officers / COLP & COFA Liability

Office Combined or EL / PL policy

Employment Practices Liability

10.3 Do you currently have insurance cover in place for the following:

Howden are able to arrange and advise on a wide range of insurance products in addition to Professional Indemnity. Please inform your Howden contact if you would like us to provide more information.

2016 PROPOSAL FORM

Page 16

SECTION 11 - SIGNIFICANT CHANGE

NoYes11.1 Does the Firm intend or contemplate any change in regulatory status in the coming year, including change to Limited Liability Partnership or Limited Company status, or transition to regulation under the Legal Services Act 2007 Alternative Business Structures regime? If YES, please provide details including a business plan.

NoYes11.2 Do you expect any significant change to, or in the Firm in the coming year? If YES, please provide details

NoYes11.3 Is there any other material information which may be relevant to this proposal? If YES, please provide details. If you are unsure as to whether information is material you are advised to disclose it.

SECTION 12 - KNOWLEDGE OF THE INSURED

Under Section 4 of the Insurance Act 2015 an Insured must disclose all material circumstances known to its `senior management' and those persons responsible for the Insured's insurance. The Act defines `senior management' as those individuals who play significant roles in the making of decisions about how the insured's activities are to be managed or organised. For these purposes please list below the positions / roles within your firm that you consider to be your Firm's `senior management' and include the roles of those persons responsible for the Firm's insurances.

Position Role

DATA PROTECTION Any information provided on this form, which may include sensitive data (e.g. medical history, criminal convictions, age), will be processed by Howden in compliance with the Data Protection Act 1998 and will only be used for the purposes of providing insurance cover and handling claims arising. In the course of our duty as insurance brokers we may be required to provide such data to limited third parties including Insurers and/or circumstance required by law. A copy of the form and any additional documents submitted should be retained for your records. DECLARATION Before signing this declaration please familiarise yourself with your 'Duty of fair presentation' which is outlined under section 1.2 at the beginning of this form. Please read the declaration carefully and sign at the bottom. By signing the Proposal Form you consent to us using the information we may hold about you for the purpose of providing insurance advice and where appropriate assistance in relation to handling claims, if any, and processing sensitive personal data about you where this is necessary (for example, criminal convictions). This may mean we have to give some details to third parties involved in providing insurance cover. These third parties may include insurance intermediaries; third party claims adjusters, fraud detection and prevention services, reinsurance companies, debt recovery agents and insurance regulatory authorities. In the course of performing our obligations to you, this information may be disclosed to agents and service providers appointed by us, and to insurers (which includes their reinsurers, legal advisors, loss adjusters and agents). Where such sensitive personal information relates to anyone other than you, you must obtain the explicit consent of the person to whom the information relates both in respect of the disclosure of such information to us and its use by us as set out above. The information provided will be treated in confidence and, where relevant, in compliance with the Data Protection Act 1998. You have the right to apply for a copy of your information (for which we may charge a fee) and to have any inaccuracies corrected. I/We declare that I/We have made a fair presentation of the risk, by disclosing all material circumstances which I/we know or ought to know or, failing that, by giving the Insurer sufficient information to put a prudent Insurer on notice that it needs to make further enquiries in order to reveal material circumstances.

Firm name:

Date

Please provide an e-signature on this page if available. If you do not have an electronic signature you can scan this page with your wet ink signature and either scan and email or fax it back to your Howden contact.

Page 17

2016 PROPOSAL FORM

SIGNATURES

Signature:

Title:

Electronic Signature:

Solicitor means a Solicitor of the Senior Courts of England & Wales. Where reference is made to a solicitor in the Firm this means any solicitor employed or retained by or otherwise acting for your Firm.

Principal means a regulated Principal of the Firm (as defined in the Solicitors' Professional Indemnity Insurance Rules 2011) recorded by the SRA. This includes any solicitor trading as a Recognised Sole Practitioner (or on their own account), and any partner, LLP member or Limited Company director in the Firm (whether a solicitor or not). If your ownership structure is more complex, for example any independent Recognised Body has an ownership interest in the Firm, we recommend you review the formal definition thoroughly and if necessary contact us for advice.

Successor Practice Whenever a solicitors' practice ceases to be carried on as a separate business, there is potential for another practice to be deemed its successor practice. If your Firm is a successor practice to any other practice then the liabilities relating to that practice may fall to be covered by your own Professional Indemnity cover and will need to be taken into account by underwriters.

The formal definition of successor practice in the Solicitors' Professional Indemnity Insurance Rules 2013 is complex and we can only provide a summary here. Your Firm may have become a successor practice in a number of scenarios, for example following a merger with another practice or your taking on work or staff from a ceased practice, even if you did not intend to take on the liabilities of that practice or specifically agreed that such liabilities would remain elsewhere (including under another insurance policy). We recommend that you review the formal definition thoroughly and if necessary contact us for advice.

Fee Income means your Firm's gross fee income derived from private legal practice as charged to clients (whether actually paid or not) and excluding VAT.

Page 16

Employee means any person who is or has been under a contract of service for or on behalf of the firm.

Senior Management means, in accordance with the Insurance Act 2015: those individuals who play significant roles in the making of decisions about how the insured's activities are to be managed or organised. Under Section 4 of the Insurance Act 2015 an Insured must disclose all material circumstances known to its `senior management' and those persons responsible for the Insured's insurance.

Documents

1. ADVICE ON COMPLETING THE PROPOSAL FORMweb-resources.hyperiongrp.com/.../solicitors-pi-proposal-form-aug-20… · 2.2 If you are the successor practice to a Firm which has purchased