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Directors & Officers Liability

Policy holder/Company name Please enter valid Policy/Company Holder Name

Address Please enter valid Address

Is the company registered/incorporated in India?

Yes No

Please choose a valid option

Is the company operating for more than 2 years?

Yes No

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Has the company been making Net Profit (ie. PAT) for the past 3 years? Annual revenue of company less than INR 500 Crores and does not have any negative networth ?

Yes No

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Is the date of the latest audited Annual Report less than 18 months old?

Yes No

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Is your company or its subsidiaries listed on ANY stock exchange? Are there any Acquisitions or Mergers with any other organization?IF yes details of same

Yes No

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Does the company have any domiciled presence outside India?

Yes No

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Directors & Officers Liability - Step 2

Are any of the directors of your company been nominated by your Management to act as the director of any entity which is registered outside India?

Yes No

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Have your Auditors made any negative comments or raised any concerns in your last audited annual report?

Yes No

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Have your financial results EVER been re-stated?

Yes No

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What is the Gross Consolidated Asset size of the company? (As per latest Balance Sheet, in Crores) Please enter valid Gross consolidated asset size

Do you currently have a Directors & Insurance Liability cover in Place?

Yes No

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Have any Claims or Claim-circumstances been reported in the past

Yes No

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What is the limit of liability required for the D&O policy? (INR) Please choose a valid option

Does your company fall under any of the below mentioned category?

Financial Services/Institution of any kind
Airlines / Aviation
Tobacco
Investment and Retirement Fund Management or Property Trust or Unit Trust Management or Stock Brokers or Security Underwriters
Biotechnology or Pharmaceuticals
Oil & Natural Gas Refining & Exploration
Real Estate development
Telecommunications/ Media - News Channel
Conglomerate/Multiple Business Activities (Eg. IT Company & Real Estate, etc.)

Yes No

Please enter valid nature of business

Nature of business of the Company: Please choose a valid option

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Directors & Officers Liability

Summary

Policy/Company Holder Name

:

ABCDEFGH
Address

:

Room no - 10, Juhu Tara Road, Juhu, Mumbai - 400049.
Is the company registered/incorporated in India?

:
Is the company operating for more than 2 years?

:
Has the company been making Net Profit (ie. PAT) for the past 3 years? Annual revenue of company less than INR 500 Crores and does not have any negative networth ?

:
Is the date of the latest audited Annual Report less than 18 months old?

:
Is your company or its subsidiaries listed on ANY stock exchange? Are there any Acquisitions or Mergers with any other organization?IF yes details of same

:
Does the company have any domiciled presence outside India?

:
Are any of the directors of your company been nominated by your Management to act as the director of any entity which is registered outside India?:

:
Have your Auditors made any negative comments or raised any concerns in your last audited annual report?

:
Have your financial results EVER been re-stated?

:
What is the Gross Consolidated Asset size of the company? (As per latest Balance Sheet, in Crores)

:

10,000
Do you currently have a Directors & Insurance Liability cover in Place?

:
Have any Claims or Claim-circumstances been reported in the past

:
What is the limit of liability required for the D&O policy?

:

10 Crores
Nature of business of the Company

: