The Insurance Proposal Form is a fundamental document in the Belgian insurance market, designed to initiate the insurance contract formation process. It serves as the primary tool for collecting relevant information about potential policyholders and their insurance needs, enabling insurers to assess risks and determine appropriate coverage terms. This document must comply with the Belgian Insurance Act of 2014, EU regulations including GDPR, and specific requirements set by the Financial Services and Markets Authority (FSMA). The form is typically used when individuals or businesses seek new insurance coverage or want to modify existing policies, requiring detailed disclosure of material facts that could influence the insurer's decision to provide coverage.
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1. Proposer Details: Basic information about the applicant including full name, address, contact details, and business/occupation
2. Type of Insurance Required: Specification of the type of insurance coverage being sought
3. Risk Details: Detailed information about the subject matter to be insured
4. Claims History: Declaration of previous claims and losses in the last 5 years
5. Current Insurance Arrangements: Details of existing or previous insurance coverage
6. Material Facts Disclosure: Section for declaring any material facts that could influence the insurer's decision
7. Payment Information: Preferred payment method and frequency details
8. Declaration: Final statement confirming accuracy of information and understanding of obligations
9. Data Protection Notice: GDPR-compliant information about how personal data will be processed
10. Signature Section: Space for date, signature, and capacity of signatory
1. Co-Insurance Details: Required when multiple parties need to be insured under the same policy
2. Professional Qualifications: Needed for professional liability insurance proposals
3. Security Measures: Required for property insurance to detail security systems and risk mitigation measures
4. Health Declaration: Required for health or life insurance proposals
5. Vehicle Details: Required for motor insurance proposals
6. Property Description: Required for building or contents insurance
7. Employee Information: Required for employer's liability insurance
8. International Coverage: Required when insurance coverage extends beyond Belgium
1. Schedule A - Risk Questionnaire: Detailed questionnaire specific to the type of insurance being sought
2. Schedule B - Privacy Notice: Detailed GDPR-compliant privacy notice and data processing information
3. Schedule C - Claims Declaration Form: Detailed form for declaring previous claims history
4. Schedule D - Value Declaration: For declaring values of property or items to be insured
5. Appendix 1 - Supporting Documents Checklist: List of required supporting documents based on insurance type
6. Appendix 2 - Terms and Conditions: Standard terms and conditions applicable to the proposal
7. Appendix 3 - Premium Calculation Guide: Information about how premiums are calculated
8. Appendix 4 - Language Selection Form: Form for selecting preferred language of communication as per Belgian language laws
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