Request a Quote for Contractual Bonus

Request a free quote for contractual bonus insurance by filling out the form below. Our experts will be in touch soon to discuss comprehensive, cost-efficient insurance for giving bonus incentives without taking a financial loss.

An asterisk (*) indicates a required field.

Insured Company Name*

Contact Name*

Phone Number*

Email*

Website

Start Date*

End Date*

Name of company

Team/Athlete

Bonus schedule (including incentive value & bonus description)

Have you had any losses in the past 3 years?

Yes

Comments

DECLARATION FOR SUBMITTING

To the best of my knowledge and belief the information provided in this application, whether in my own hand or not, is true and I have not withheld any material facts. I understand that Non-disclosure or misrepresentation of a material fact will entitle the company to void the Insurance. I understand that submitting this Application does not bind me to complete the insurance but agree that should an insurance policy be issued, this Application and the statements made therein shall form basis of the insurance policy.

(By clicking “submit” below you are agreeing to the following statement)

Comments

This field is for validation purposes and should be left unchanged.