Voluntary Workers & Group Accident

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  1. This policy is only available to Australian domiciled persons.
  2. Where did you hear about Action Entertainment Insurance?
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  3. Have you previously spoken to an Action Representative regarding this quote?(*)
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  4. Name of representative?
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  5. Name of Insured(*)
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  6. ABN
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  1. Are you completing this proposal as a client or broker on behalf of the client?(*)
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  2. Brokerage Name (*)
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  3. Contact Name(*)
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  4. Postal Address(*)
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  5. Suburb(*)
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  6. State(*)
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  7. Postcode (*)
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  8. Phone Number(*)
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  9. Fax Number
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  10. Email Address (*)
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  11. Website Address
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  12. Clients Address (*)
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  13. Clients Website Address
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  1. Period that cover is required(*)
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  2. Start Date
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  3. End Date
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  4. Your Business Description(*)
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  5. How many volunteers will you engage to work for you over the period of insurance?(*)
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  6. What activities or duties will the volunteers be undertaking?(*)
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  7. Please advise number of volunteers and how often they will work during the following periods (if not applicable, please answer with '0'
  8. Weekly
  9. Number of Volunteers(*)
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  10. How many days per week(*)
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  11. Monthly
  12. Number of Volunteers(*)
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  13. How many days per month(*)
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  14. Yearly
  15. Number of Volunteers(*)
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  16. How many days per year(*)
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  17. Specific Event
  18. Number of Volunteers(*)
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  19. How many days per event(*)
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  20. Please advise age ranges (approx) of these persons:
  21. Youngest(*)
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  22. Oldest (*)
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    Note: For Volunteers aged 65 years and older reduced sums insured and / or restricted benefit may apply
  1. Will the Volunteers duties involve any of the following
  2. Lifting heavy equipment
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  3. Working from heights
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  4. Please advise max height?
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  5. Sporting activities
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  6. What type of sport?
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  7. Acrobatic, aerial or trapeze
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  8. Dangerous or Hazardous work
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  9. Please provide details
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  10. Driving Vehicles
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  11. Will you be paying these persons to work for you?
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  12. Please advise payment amount to workers?
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    Note: Please be aware that you might be required to arrange a workers compensation policy to cover these persons. Workers Compensation Insurance is compulsory for all employers.
  13. Have your ever suffered any claims or incidents where persons working for you have been injured?(*)
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  14. Please provide details
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  15. Have you previously been refused insurance or have had your insurance cancelled by an Insurer or have had special conditions, increased premiums or increased excesses imposed on any policy of insurance by an Insurer?(*)
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  16. Please provide details
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  1. BENEFITS TO BE INSURED (per person) OPTION A OPTION B
    Capital Benefits: $ 50,000 $ 100,000

    Weekly Injury Benefits:(Limited to the lesser of 85% of weekly wage or)

    $ 500 $ 750
    Excess Period 7 Days 7 Days

  2. Please select Benefits to be Insured(*)
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  3. Please advise Benefit limits required
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  1. Disclaimer

    Privacy Policy

    At Action Entertainment Insurance Pty Ltd Corporate Representative No. 237473 as an authorised representative of Action Insurance Brokers P/L AFS 225047, we are committed to protecting your privacy in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. This Privacy Policy describes our current policies and practices in relation to the collection, handling, use and disclosure of personal information. It also deals with how you can complain about a breach of the privacy laws and how you can access the personal information we hold and how to have that information corrected.

    Please visit https://www.entertainmentinsurance.net.au/privacy-policy to read our full privacy policy.

    Your Duty of Disclosure

    When entering into a contract of general insurance you need to tell us

    Before you enter into a contract of general insurance with us, you have a duty, under the Insurance Contracts Act 1984, to disclose to us every matter that you know, or could reasonably be expected to know, is relevant to our decision whether to accept the risk of the insurance and, if so, on what terms.

    When entering into a subsequent or renewing a contract of general insurance

    You have the same duty to disclose any matter to us before you renew, extend, vary or reinstate a contract of general insurance, which may affect our decision to insure you.

    What you are not required to disclose

    Your duty does not require disclosure of any matter:

    1. That diminishes the risk to be undertaken by us;
    2. That is of common knowledge;
    3. That we know or, in the ordinary course of our business, ought to know;
    4. Where compliance with this duty is waived by us.

    Non disclosure and its consequences

    If you fail to comply with your duty of disclosure at law, and/or have not answered our questions honestly and not told us what you, as a reasonable person in the circumstances would have answered, we may be entitled to reduce our liability under the contract in respect of a claim or may cancel the contract.

    Fraudulent non disclosure and its consequences

    If your non disclosure is fraudulent, we may also have the option of avoiding the contract from its beginning.

    Subrogation

    You may prejudice your rights with regard to a claim if, without prior agreement from the Insurer, you make agreement with a third party that will prevent the Insurer from recovering the loss from that, or another party.

    Your policy contains provisions that either exclude the Insurer from liability or reduce their liability, if you have entered into any agreements that excludes your rights to recover damages from another party in relation to any loss, damage or destruction which would allow you to sustain a claim under this policy.

  2. I have read and understand the Statutory Notices:
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  3. I have read and understand the Subrogation Clause
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  4. Anti-Spam(*)
    Anti-Spam
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  5. Submit

Action Entertainment Insurance Pty Ltd ABN 20 103 891 265 Corporate Representative No. 237473 as an authorised representative of Action Insurance Brokers P/L ABN 39 080 844 426 AFS 225047

Privacy Policy
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