Insurance Details
Church Contact Details
Church Name
Main Contact for Insurance
Contact's Phone Number
Contact Fax
Contact's Email
Insurance Details
Combined Insurable Value of Church Properties
Please itemize all buildings with insured value
Church Value
Manse Value
Other Value
Name of Current Insurer
Insurance Renewal Date
Please indicate the range of current insurance and coverage amount
Public Liability
Professional Indemnity
Professional Indemnity
Public Liability Amount
Professional Indemnity Amount
Does your current insurance include coverage for sexual molestation?
Yes
No
No
Does you current insurance include Director's and Officer's insurance?
Yes
No
No
Do you have Voluntary Workers Personal Accident coverage on your current policy?
Yes
No
No
Have you had any claims experience in the last 5 years in any of your church's insurance policies?
Yes
No
No
If so, please provide detail (Include year, value of claim and description of claim)
