Professional Indemnity Insurance Cover for Companies

Including Close corporations, partnerships and other incorporated entitities
If you move your mouse (hover slowly) over the blue questions marks that you see on the form below, you will see additional information about that particular question and hints or guidelines on how to complete the question.

Qualifying criteria
Claims or Complaints
This serves as further confirmation that you have declared that there are no claims pending as per the questions on the previous screen and that you comply with qualifying criteria regarding the size of the business as per the questions on the previous screen. If this is NOT correct, please click here to be taken to the appropriate screen in the registration process. ?
Record of Advice Documents & Authority

Please do not proceed until you have read these documents in their entirety. This PDF Documents will open in a separate browser window/tab for you to read. When you have done so, come back to this window / tab to proceed to complete the form.

Please click on the name of the document (blue) to open it for reading (and saving to your computer).

(a) SACNASP Master Policy Document and Notes - General .
(b) SPIIS Additional Documents and Notes for Company Cover . I confirm that I have read, understood and agree to comply, on behalf of the company, with the contents of the (a) SPIIS Master Policy Document and Notes - General. This document also includes the Hollard FAIS Disclosure Notice and the CFP Brokers FAIS disclosure Notice; and (b) the SPIIS Additional Documents and Notes for Company Cover.

In the event that I accept the quote that is generated after I have completed this questionnaire, I confirm that by payment of the premium due, I authorise and instruct CFP Brokers CC to place professional indemnity insurance for the company with the Hollard Insurance Company Limited.
Indemnity Insurance
Company insurance history
Previous Insurance ? Company has been previously insured
Company has NEVER had insurance
Previous Insurance company ?
Policy or certificate number of our expiring policy document. ?
Previous / Current Policy Expiry Date ?
Please enter the retroactive cover date that appears on your expiring (previous) policy schedule: ?
Indemnity Insurance Cover required
New Cover required
Limit of Indemnity required for the company ? R 1,000,000 Cover (excess R 5,000.00 per claim)
R 2,500,000 Cover (excess R 5,000.00 per claim)
R 5,000,000 Cover (excess R 5,000.00 per claim)
R 10,000,000 Cover (excess R 10,000.00 per claim)
R 15,000,000 Cover (excess R 15,000.00 per claim)
R 20,000,000 Cover (excess R 20,000.00 per claim)
We require this cover to incept (start) on: -
Enter the date that you require this new Indemnity Insurance Cover to start.
Please ensure that if you have cover in place currently (or cover that has lapsed recently - less than 2 months ago on the CFP SACNASP Scheme policy) that this policy incepts from the day after the expiry date of you expiring policy. You should not leave any "gaps" in your cover as doing so could result in your forfeiting any retroactive cover that you are entitled to by virtue of your previous cover. If you are moving from another policy and your cover has lapsed, we would recommend that you purchase retroactive cover but please be aware that retroactive cover is not a gap infill.
Retroactive Cover required
I confirm that I have read and understood the contents of the document SACNASP Master Policy Document and Notes - General: Notes on claims-made and retroactive cover .    ?

Gaps in Indemnity Cover - Please select one of these options:

Option 1: I confirm that there are no ´gaps´ between our previous professional indemnity insurance that is expiring and the date that I would like this cover to incept from. Please note that Hollard will require you to provide proof of any previous insurance in the event of a claim. We therefore urge you to secure copies of all previous professional indemnity insurance policies and ensure that you can access them should the need arise.

Option 2: The company's previous insurance lapsed and there is therefore a gap in cover between this cover and the previous insurance that we had in place. Furthermore, I understand that, we have lost all the retroactive cover and that we are therefore not entitled to any retroactive cover under the SPIIS policy unless we choose to purchase retroactive cover under the SPIIS policy. I understand that a gap of even one day will cause the loss of all retroactive cover.

Option 3: The company has never had insurance before.

Retroactive [backdated] cover should be taken out if you have been rendering services in the past without any cover in place or if there has been a ‘gap’ in your cover. If you have had existing cover on our SACNASP scheme policy the gap can be no longer than 2 months but if you have had other cover you cannot have a gap at all.

Please will you phone us to discuss this if you are not sure whether or not you need retroactive cover.

It is important to note that even if you do take out retroactive cover it will not cover you for claims arising from incidents that you are already aware of or which you should reasonably be aware of that could lead to a claim or complaint against you.

Please keep copies of your previous insurance certificates or policy schedules as proof of your retroactive cover entitlement.

We would like to purchase Retroactive Cover and understand that the annual premiums will be loaded by the percentage indicated in order to include this cover: 1 years retroactive cover – 20% per SACNASP registered member
2 years retroactive cover – 25% per SACNASP registered member
3 years retroactive cover – 30% per SACNASP registered member
I do not require any retroactive cover
Company Information
Basic Details
Company Name (trading name): ?
Registered Company Name in full: ?
Company Registration Number: ?
Choose a password (8 or more chars) for the SPIIS system ?
Repeat your password ?
VAT Registration Number ?
Landline Telephone Number ?
Company Website Address (or leave blank) ?
Full name of the contact person at the company who we should communicate with for purposes of this insurance: ?
Cell or Phone Number of contact person ?
E-Mail address of contact person ?
Address Details
Physical Street Address
Physical Street Address ?
Suburb ?
City or Town (no abbreviations) ?
Postal Address - must be completed or please repeat your Physical Address
P O Box Number/Street and Number ?
Suburb ?
City or Town (no abbreviations) ?
Postal Code ?
Services and Staff
Primary Field of Practice: (as per the same categories of SACNASP)
Describe the Services that your company provides: ?
Total number of DIRECTORS as at date of application (please include total number regardless of whether any of the directors do not qualify for SACNASP registration. Please note that in the event of a claim you will need to provide the insurers with proof that you furnished the correct answer to this question).
Total number of company´s directors who qualify for SACNASP registration or who have applied for SACNASP registration as at date of application.
Total number of employees as at the date of application (please do not include the directors for purposes of answering all questions pertaining to employees of the company).
Total number of employees who qualify for SACNASP registration or who have applied for SACNASP registration.
Please note: On the next page (after saving this application) you will be given the opportunity to complete a full listing of all directors and employees who require cover as per the SPIIS.
Confirmation of all conditions
Full name of person completing this application form on behalf of the company ?
Position/Capacity of person completing this application form on behalf of the company. ?
I warrant that I have the necessary authority to complete this application form for and on behalf of the company. ?
I confirm, understand and accept the following conditions:

  1. There is an excess/deductible which is applicable to each and every claim. The excess is payable as soon as Insurers incur costs in your defence regardless of the final outcome of the claim. The main excess depends on your main limit of indemnity as indicated in the "New Cover required" section,
  2. That the Company will be charged the full annual premium regardless of when this application is submitted
  3. That I have read and understood the contents of these entire documents:
    (a) SACNASP Master Policy Document and Notes - General plus the document
    (b) SPIIS Additional Documents and Notes for Company Cover
  4. I confirm that Hollard´s Disclosure Notice has been provided to me via access on the on-line registration system and/or in the Master Policy Document.
  5. I confirm that CFP Broker´s Disclosure Notice has been provided to me via access on the on-line registration system and/or in the Master Policy Document.
  6. Furthermore, I confirm that all information provided by me in this application is true and correct. I understand that my failure to provide true and correct information in this application could lead to the cover being voided in the event of a claim.

Please carefully check all the information that you have provided on this form. Once you click the button below you will NOT BE ABLE TO MAKE ANY FURTHER CHANGES TO THIS DATA.

When you click the button your application will be saved, you will be taken to a screen to fill in the details for the Personnel to be insured.