CYBER Header Image

Please complete the form below to purchase Cyber Liability insurance

Duty of Disclosure

Before you enter into an insurance contract, you have a duty to tell the insurer anything that you know, or could reasonably be expected to know, that may affect the insurer’s decision to insure you and on what terms.

You have this duty until the insurer agrees to insure you.

You have the same duty before you renew, extend, vary, or reinstate an insurance contract.

You do not need to tell the insurer anything that:

  • reduces the risk they insure you for; or
  • is common knowledge; or
  • the insurer knows, or should know; or
  • the insurer waives your duty to tell them about.

If you do not tell the insurer something

If you do not tell the insurer anything you are required to, they may cancel your contract, or reduce the amount they will pay you if you make a claim, or both.

If your failure to tell the insurer is fraudulent, they may refuse to pay a claim and treat the contract as if it never existed.

Duty of Disclosure Acceptance*

Insurance Details

Admin Status
Reason for Refund
POLICY AGGREGATE LIMIT OF LIABILITY:*

Policy Period

Policy date can be set up to 58 days from today.
Policy Start Date
Expiry
If you have a business name (even if you are a Sole Trader), you should select 'business' above
Do you have a business name or trading name?*


The following limits apply to your policy:

Aggregate LimitWaiting PeriodStandard Retention

$1,000,0008 hours$1,000 (refer to schedule for full breakdown)

Premium (Business)

This credit card fee is calculated based on a fee of 1.75% + 30c per transaction.

Premium (Individual)

This credit card fee is calculated based on a fee of 1.75% + 30c per transaction.

Important Information

The insurance is issued by BMS Risk Solutions Pty Ltd (BMS) AFSL 461594, ABN 45161187980 under binder with Certain Underwriters at Lloyds. When acting under a binder BMS acts as agent for the insurer and not as your agent.

This is general advice only and we have not considered whether it was suitable for your personal objectives, needs or financial situation.

Please read the Policy Wording/Product Disclosure Statement and Financial Services Guide before making any decision about purchasing this policy.

Please take this opportunity to read the following important documents:

To the extent that there is any inconsistency between the terms of the policy and the FSG provided to you by BMS, the terms of the policy will prevail.

Your Acknowledgement*

Confirmation Page

First Name {$108316716 ‪First Name‬}
Last Name {$108316717 ‪Last name‬}
Phone {$108316719 ‪Phone Number‬}
Email {$109627824 ‪Email‬}
Address {$108316725 ‪Street‬}, {$108316726 ‪Suburb‬}, {$108316727 ‪State‬}, {$108316728 ‪Postcode‬}
Business Name {$108316721 ‪Business Name‬}
   
Premium ${if Are you an Individual or a Business? =='Business'}{$108316737 ‪Premium‬}{else}{$108388828 ‪Premium‬}{/if}
GST ${if Are you an Individual or a Business?‬=='Business'}{$108316738 ‪GST‬}{else}{$108388829 ‪GST‬}
Stamp Duty ${if Are you an Individual or a Business?‬=='Business'}{$108316739 ‪Stamp Duty‬}{else}{$108388830 ‪Stamp Duty‬}
Broker Fee ${if Are you an Individual or a Business?‬=='Business'}{$108316740 ‪Broker Fee‬}{else}{$108388831 ‪Broker Fee‬}
Broker Fee GST ${if Are you an Individual or a Business?‬=='Business'}{$108316741 ‪Fee GST‬}{else}{$108388832 ‪Fee GST‬}
Credit Card Fee ${if Are you an Individual or a Business?‬=='Business'}{$108316743 ‪Credit Card Fee‬}{else}{$108388834 ‪Credit Card Fee‬}
Total Payable ${if Are you an Individual or a Business?‬=='Business'}{$108316744 ‪Total Payable‬}{else}{$108388835 ‪Total Payable‬}
   
Inception {$108316734 ‪Inception‬}
Expiry {$108316735 ‪Expiry‬}
Limit of Liability {$108316729 ‪POLICY AGGREGATE LIMIT OF LIABILITY:‬}
Save and Resume Later
Powered by Formstack Create your own form