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Errors & Omissions (E&O) Indemnity Application Form

We've made it easy for you to apply online!

Looking for Errors & Omissions (E&O) Indemnity cover can be extremely time consuming and often very frustrating. At Builtin we aim to make the process of obtaining E&O Indemnity as simple as possible.

We deal only with one insurer who is able to offer comprehensive insurance cover at extremely competitive rates.

Click here to find out "What you must tell us"

You must tell us all information you know (or could reasonably be expected to know) which would influence the judgement of a prudent underwriter whether or not to accept your application, and if it is accepted, on what terms and at what cost.

Examples of information you may need to disclose include:
• anything that increases the risk of an insurance claim;
• any criminal record;
• if another insurer has cancelled or refused to renew insurance, or has imposed special terms;
• any insurance claim you have made in the past.

Examples of information you do not need to disclose include:
• anything that reduces the risk of an insurance claim;
• anything we say you do not need to tell us about;
• anything that is common knowledge;
• anything you have already told us, or that we should be expected to know in the ordinary course of our business.

These examples are a guide only. if you are not sure whether you need to disclose a particular piece of information, please ask.

WHEN in doubt – disclose. All information will be treated confidentially.

Please answer all questions. Blanks and/or dashes, or answers 'known to underwriters or brokers' are not acceptable and will delay consideration of this proposal.

Where appropriate, please tick the Yes or No box which best indicates your reply.

Builders Errors & Omissions (E&O) Indemnity Application Form
  
Your Details    
  Name of your business or company  
  Contact name  
  Telephone  
  Your email address
(our preferred method of communication) 		 
  Postal Address

 
  Area of your operations  
  Main trade / occupation  
  Your target market? Residential Commercial Both  
  If you have selected Both then, please enter percentage?
Residential %
Commercial %
 
       
Business Details    
  How many years experience do you have in the trade?  
  How long have you been in business? years  
  Trading style  
  Number of principals and employees  
  Are you a member of a trade association?  
  If other is selected, please enter details  
       
Cover    
  Errors & Omissions cover –  limit required  
  Maximum turnover past 12 months  
  Estimate maximum turnover next 12 months  
  Do you wish to take Run-Off Cover, if no longer trading? Yes No  
  if Yes, when did you cease trading?  
  Do you wish to include one Automatic Reinstatement of the Limit of Liability in the event of a claim? Yes No  
  Names of up to two LBPs to be automatically covered by the License Defence Costs clause    
  LBP Name 1  
  LBP Name 2  
  Do you wish to include Licensed Building Practitioners (LBP) Defence Cost Cover for Breach of Statutory Obligations for additional employees? Yes No  
  LBP Name 3  
  LBP Name 4  
  Has legal action been taken against you for any alleged error or omission? Yes No  
  If Yes, please provide details  
       
Claims History    
  How many continuous claim-free years have you been insured for E&O Liability?
 years  
 

In respect of any of the risks proposed, have you or any partner or director suffered any loss, made a claim or been involved in incidents which have resulted in a claim, whether covered by insurance or not?

 Yes No  
  If you answered 'Yes' to the above question, please provide details  
  Previous/current insurer(s)  
       
Other Details    
  How did you find out about
Builtin Errors & Omissions (E&O) Indemnity cover?		 I am a Certified Builder
Through a Certified Builder
Google or other Search Engine
Advertising
Other
 
  Are you an approved broker? Yes No  
       
Cover Details    
  What date do you want the cover to start from?  
  Can we contact you in the future via e-mail with details of other products and services that we offer? Yes No  
       

 

 I hereby declare that the above statements are true, and I have disclosed all material facts and should any information given by me alter between the date of this proposal form and the inception date of the insurance to which this proposal relates I shall give immediate notice thereof.  
       

 

 I authorise Builtin New Zealand Ltd on behalf of the underwriter, CBL Insurance Limited, to collect or disclose any personal information relating to this insurance to/from any other insurers or the Insurance Claims Register.  
       

 

 I also confirm that I am authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this proposal form and I complete this proposal form on their behalf and with their consent.  
       
 

Freephone

0800 BUILTIN

bi-list_arrow_grey.pnginfo@builtinnz.co.nz

Run Off Cover

Option to continue cover when business ceases.

Even though you may no longer be trading, you could still be liable for up to 10 years. This extension provides cover at reduced cost during this "run off" period.

One Automatic Reinstatement of the Limit of Liability

Option to automatically reinstate Limit if a claim is paid.

If a claim is made the Limit will be reduced by the amount of the claim paid. This extension allows you to immediately return to the full original limit.

Defence Cost Cover for Breach of Statutory Obligations (LBP Defence Costs)

The policy automatically includes defence costs cover for up to two named LBPs.

Option to cover legal costs for defending additional nominated LBP employees from proceedings brought by the Licensed Building Practitioners Board to revoke your license.

Yours and your employees' Licences are vitally important these days, because without them you can't do restricted building work. This extension will pay the costs of action to keep those licenses, so you can continue to build.