Malpractice & Liability Insurance
for the Allied Health Industry

Premiums start at $550.00 per year
(GST & Stamp Duty included) for:

$1,000,000 Malpractice (Professional Indemnity) &
$10,000,000 Public Liability cover.

To receive a confirmed quote, please complete the form below. You will receive a confirmed quote on the same business day or the next business day if received after hours.

If you prefer to talk to a broker first, please call 1300-881-779 between 8.15am and 5.15pm E.S.T. business days and receive an indicative quote over the phone.


Client Details

If you have spoken to a broker in our office, note their name here so that this quote can be processed by them as they will know something about you already.

Brokers Name:

Insured Name

Trading Name

ABN No.(if known)

Full Address

Email Address

Website Address

Phone No.

Is cover for any subsidiary or associated company required?
Yes    No

Does Your business incorporate any prior trading entities?
Yes    No

Professional Duties

What is your occupation? (eg.Aromatherapist)

Please provide Us with a full description of Your business activities.

Risk Information

Do all staff performing services have the minimum qualifications required to the general accepted standards of the Business Activities / Services provided?
Yes    No

Do you manufacture, alter, repair, repackage or import any Products for sale?
Yes    No

* Please note that there is no cover for private label products.

What percentage of your turnover comes from the sale of Products?

Do you use a medical history / client information form in all cases?
Yes    No

Do you use a hold harmless or informed consent form?
Yes    No

Quote Required

Please nominate the amount of cover you require:

Malpractice Insurance
(Professional Indemnity)


Please nominate the amount of cover you require:

Public Liability
Not required

* Standard cover is $1,000,000 Malpractice & $10,000,000 Public Liability cover


Underwriting Questions

No. of full time employees:  

No. of part time employees:

Gross Revenue - last year   If Nil, put in "0"


  USA or Canada


Estimated for next year   If Nil, put in "0"


  USA or Canada




Do you employ contractors or sub-contractors?
Yes    No

If you answered YES
what duties do they perform??

Do You require cover for sub-contractors?
Yes   No

If "NO", do You insist they carry their own insurance?
Yes   No


Your History

During the past 10 years, has any claim been made against you, your principals, employees or consultants for Medical Malpractice, Public Liability, Professional Liability or had any circumstance been notified to the insurers that might give rise to a claim?
Yes    No

Is any applicant aware of any claim or circumstances that might give rise to a claim against the Business or any prior business of any of their present or former Partners, Principals or Directors, which matter is not referred to above?
Yes    No

Has any applicant ever had a Liability Insurer decline to continue the applicant's insurance or cancel their insurance?
Yes    No

Has any applicant ever been subject to disciplinary proceedings for professional misconduct?
Yes    No

Have you (or any person receiving cover under this policy) ever:

  • Been involved in a company that has been declared bankrupt or insolvent?
  • Been liable for any civil offence or pecuniary penalty?
  • Been charged or convicted for any criminal offence?
  • Been charged or convicted for fraud, theft or dishonesty?
Yes    No

Type the above number:


By submitting this Declaration, the Applicant acknowledges:

  • they are authorised by each of the other Applicants to make this Declaration,
  • the contents of the Declaration are true and complete,
  • they are under a continuing obligation to immediately inform the insurer of any change in the particulars or statements contained in this Declaration or in the accompanying documents up until the contract is entered into,
  • they authorise the insurer to give or obtain from other insurers or insurance reference bureaus or credit reporting agencies, any information about this insurance or any other insurance held by the Applicant/s.

Name of person making this declaration: