Employers Liability EL Quote Form - Dec 2023

Request a Quote
Information about the Employers Liability Policy and Morton Michel

This policy is designed to meet the needs of Householders who employ Nannies, Carers or Domestic Staff.

You will usually be considered to be the Employer of anyone who works in your home if you hire them, and they are not Self Employed or paid through an agency.

Fair Presentation of the Risk

It is important that this information is accurate and correct as you have a duty to make a fair presentation of the risk to insurers. The terms of any insurance that we arrange on your behalf will be based upon the information provided by you to us or to your insurers.

You have a duty to make a ‘fair presentation' of the risk for which you are seeking insurance cover. This means that you must clearly disclose every material circumstance which you, your senior management or persons responsible for arranging your cover is placed, when it is renewed and at any time it is varied. Your policy wording may also stipulate that this duty continues throughout the period of insurance cover. A material circumstance is one that may influence the insurer's decision over whether to take the risk and, if so, on what terms. If you are in any doubt as to whether a circumstance is material you are advised to disclose it.

Failure to disclose a material circumstance may entitle an insurer to impose different terms on your cover or reduce the amount of a claim payable, and in some cases your cover could be invalidated which would mean that a claim would not be paid.

You are advised to keep copies of any correspondence you send to us or direct to your insurers.

If you fail to advise us of any changes or provide inaccurate information then your policy may not be valid, or the policy may not cover you fully or at all. If you have any questions please call and speak to our friendly customer service team who will be happy to talk you through your policy, your additional benefits and the renewal process.
About You
Title*
Other
Proposers name in full*
(* indicates mandatory field)
Is this policy to be in joint names?

YesNo
Please enter additional Title and Name below
Title*
Other
Proposers name in full*
(* indicates mandatory field)
DOB*

DayMonthYear
Date
Telephone Number*
Mobile Number*
Email address*
Address*

Street Address

Street Address Line 2

City/TownCounty

Postcode
When do you wish this insurance to commence

DayMonthYear
Proposer/Policyholder History

It is important that you read the following statements carefully. If applying for a joint policy these statements must be agreed by both proposers.

General*

	Agree	Disagree
You have not been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or an Individual Voluntary Arrangement.
You have not been the subject of a County Court Judgement (or Scottish equivalent) and there are no proceedings pending.
You have not been the subject of a Debt Relief Order and there are no applications pending.
You have not been a principal, director or partner in any business which is or has been the subject of a winding up or administration order, receivership proceedings or a Company Voluntary Arrangement.
You have not been convicted of or charged with (but not tried) or received a police caution in connection with any criminal offence (other than motoring offences). Note: Convictions regarded as spent under the Rehabilitation of Offenders Act 1974 do not need to be disclosed.
You have not been prosecuted or received notice of intended prosecution, issued with a simple caution or been served with a prohibition or improvement notice in connection with any breach of health and safety legislation.

Previous Insurances*

	Agree	Disagree
No Insurer or insurance provider (including Morton Michel) has ever declined your proposal (i.e. refused to provide an insurance quotation for you), refused to offer renewal of, or cancelled your policy or imposed special terms or conditions.
You have implemented any requirements made by previous insurers as a condition for the provision of insurance cover.

Claims*

	Agree	Disagree
You have not suffered any losses, made any claims or had any claims made against you in respect of death, injury, damage to property, financial loss, legal expenses or debt recovery claims during the last five years, whether insured or not, in respect of any of the risks which you now wish to insure.

Employment Details

Please advise of the type(s) of employees you have and provide the following details:
Annual Wages / Salaries Estimates

Please provide us with the wages split between your different types of employees. Annual Salary must be the total salary for the year not per hour. Please also indicate the estimated maximum number of employees at any time during the proposed period of insurance within each category.
Please advise of the type(s) of employees you have:*

Domestic helperCarerNanniesOther
Please provide the following details:
Domestic helpers
Annual salary :
This must be the total salary for the year not per hour
Maximum Number of this type of employee at any time:
Carers
Annual salary :
This must be the total salary for the year not per hour
Maximum Number of this type of employee at any time:
Nannies
Annual salary :
This must be the total salary for the year not per hour
Maximum Number of this type of employee at any time:
Other
Annual salary :
This must be the total salary for the year not per hour
Maximum Number of this type of employee at any time:
Employers Liability Tracing Office (ELTO) Declaration
Are you required to be registered with HMRC as an employer operating PAYE?

YesNo
What is your ERN number?
You will only be issued with an Employer Reference Number (ERN) if you are required to register with HMRC as an employer operating PAYE (because you have employees earning above the PAYE threshold of £490.00 monthly). It is often referred to as an employer PAYE reference and is usually in the format of 3 numbers/2 letters, 5 numbers, e.g., 123/AB12345. This does not apply to businesses registered in Guernsey & Jersey
You are completing this form to submit your details to Morton Michel so that we can contact you with a quote. The data you provide will be retained to provide you with details of our insurance services. If at any time you want your data removed from our systems please let us know. Our Privacy Notice lets you know how we use your data and how to request removal.
I agree to the Privacy Notice*

Yes
Should be Empty:

Request a Quote

Information about the Employers Liability Policy and Morton Michel

Fair Presentation of the Risk

About You

Proposer/Policyholder History

Employment Details

Domestic helpers

Carers

Nannies

Other

Employers Liability Tracing Office (ELTO) Declaration