IIRSM Insurance Questionnaire 1. IIRSM Insurance Questionnaire IIRSM have teamed up with insurance brokers, Belmont International, to look to provide a range of member benefits that could reduce the cost of insurance for members or improve the cover that is provided. In order to put together the most suitable products to meet Members requirements could you take a little time to complete this questionnaire. Question Title * 1. On what basis do you operate? Own consultancy firm Self-employed Contract or project work As a company employee Question Title * 2. Do you currently purchase Professional Indemnity Insurance? Yes No Question Title * 3. In what type of Business do you operate (tick all as appropriate) SME Health and Safety Corporate Health and Safety Environmental Oil & Gas Occupational Health Office Construction Transport Specialist Scientific or Military Local Authority Manufacturing Other Specialism's (please specify) Question Title * 4. Which of the following turnover bands applies for your business? Up to £100k £100 - £150k £150k - £200k £200k - £250k £250k - £300k £300k - £400k £400 - £500k Over £500k Question Title * 5. Would you be interested in incorporating your Office insurance, Public Liability, Employers Liability and Professional Indemnity into one package with premiums payable on monthly interest-free direct debit? Yes No Question Title * 6. If NO, is this because: (see question 5) Policies have different renewal dates Prefer to keep them separate Do not purchase all the products Any other reason: (please specify) Question Title * 7. We are keen to provide a broad range of insurance benefits where preferential premiums or enhanced policy cover could be achieved for members. Would you be interested in the following? (tick all those that would be of interest) Home Insurance Travel Insurance Private Medical Insurance Pensions (company or individual) Life or Keyman Insurance Motor (Private car or Fleet) Mortgage Service Question Title * 8. Optional Name: Membership Number: Thank you for completing this questionnaire. Your assistance is appreciated in enabling us to design the most appropriate products and benefits for IIRSM Members. Done