Professional IndemnityInsurance Application Form

For ABDO members

Association of British Dispensing Opticians

Please complete the details below to applyfor this cover.

• I am a qualified Dispensing Optician residingin the UK and agree to abide by the Termsand Conditions of the ABDO ProfessionalIndemnity Insurance policy. • I understand that I will be covered under thePolicy only up to the date to which mysubscription fees are paid.• I have had no claims in the past and I am notaware of any pending claims against me.• My payment (made payable to “ABDO”) isenclosed for £35 / £45 / £65 (or £17.50 forFBDO’s qualifying after 31 May this year)

Signed:

Date:

Name:

Membership number:

Payment by credit/debit card(This section MUST be completed in full)

Please debit my account for insurance fees for the

total amount of

£ •

Card number:

Card type: VISA Mastercard Maestro

Note:We do not accept American Express or Visa Electron

Expiry date: /

Start date: /

Security code:

(Last 3 digits on signature strip on reverse of card)

Issue no: (Maestro only)

Name of cardholder:

Signed:

Date:

Address of cardholder:

Postcode:

Telephone:

Please return with your payment to: ABDO Membership Services, Godmersham Park,Godmersham, Canterbury, Kent CT4 7DT.Fax 01227 733 900.

Once payment is received, we will send youconfirmation of your cover.

Payment by chequePlease make cheques payable to ABDO

Association of British Dispensing Opticians

Professional Indemnity Insurance application

All ABDO members (qualified as FBDO)must obtain or retain Professional IndemnityInsurance.

The ABDO scheme is only available toMembers of the Association who are fullyqualified Dispensing Opticians, residing inthe United Kingdom. The policy covers theInsured (including the fitting of contactlenses, if so qualified), and any subordinatesworking under his/her guidance anddirection. It does not cover optometric work.

The current fee is £35.00 for DispensingOpticians and £45.00 for Contact LensOpticians or £65.00 if you are MECs Certifiedfor the calendar year January to December.Please note that no pro rata fee or refund isoffered should you join or leave the schemeduring the year (with the exception ofnewly-qualified FBDO’s, qualifying after 31May, who may pay a reduced fee of £17.50if joining the scheme in the year ofqualification). Once selected, yourinsurance will renew automatically eachJanuary, with your annual membershipsubscription. Cover will remain in forceprovided payment is received by 31January in the year the fees are due (unlesspaying in instalments by Direct Debit).Failure to pay your ABDO membershipsubscription and/or your ABDO ProfessionalIndemnity Insurance fee will result in yourwithdrawal from the Scheme.

The following is a brief guide to the policy.It does not form the basis of the insurancecontract:

Breach of Professional Duty• £5,000,000 for claims arising out ofneglect, error or omission in providingdispensing advice in the course of thebusiness subject to policy terms andconditions.

Please contact the Insurance Brokers, GDAnderson & Co Ltd, tel: 020 7437 5122, if youhave any specific queries.

The policy itself may be viewed at theABDO office in Kent, by appointment.

August 2018

ABDO Membership ServicesGodmersham Park, Godmersham, Canterbury, Kent CT4 7DTTelephone 01227 733 902 • 01227 733 912 • 01227 733 922 Fax 01227 733 900Email membership@abdo.org.uk Website www.abdo.org.uk