About this form
The information you provide in this Application Form will help Kobe assess your insurance needs. It will also be shared with underwriters to help source the best cover for you. Please complete this openly and honestly because you do have a Duty of Disclosure.
Duty of Disclosure
Before submitting this application, we have to tell you about your duty of disclosure at law which applies until an insurer agrees to insure you.
We will ask you questions that are relevant to our decision to insure you and on what terms. When answering our questions, you must tell us anything that you know and that a reasonable person in the circumstances would include in their answer. If you do not tell us anything you are required to, we may cancel your policy or reduce your claim, or both. If your failure is fraudulent, we may refuse to pay your claim and avoid the policy altogether.
, including for the processing of this application and providing cover.
Period of Insurance Start Date
(12 months cover)
Limit of Indemnity Required
In the last 5 years, have you:
Have you or your Partners or Directors: