Directors and Officers Liability Policy

Company Details
Name of Company *
Year Of Incorporation *
Total Assets *
State *
Select City *
Pincode *
CIN Number *
Reg. Office Address *
Jurisdication *
Geographical Area *
Terroritory *
Details of the Directors
Name *
Address *
Position *
Questionnaires Details
Name of Company *
Country of Registration *
Business Activities of the Company? *
Has acquisition or merger taken place? *
The capital structure of the parent Company changed? *
Has the company any acquisition/tender offer/merger pending/under consideration? *
Is the Company intending a new public offering of securities within the next year in India , or elsewhere *
Is the Company Private *
Listed on any Indian Stock Exchange *
Traded in any other way? *
Total Number of Shares issued *
Total Number of shares held by Directors and Officers (both direct and beneficial) *
Please give a list of Directors and Officers of the Company *
If the parent Company has Subsidiary Companies *
Has the Company ever had any Insurer decline a proposal or cancel or refuse to renew a Directors and Officers Liability Insurance ? *
Is the Proposer aware, after enquiry, of any circumstances of incident which may give rise to a claim ? *
The accounts are duly audited and submitted with all required regulatory Authorities *
Address of Head Office *
How long has the Company continually carried on business? *
Has parent company been changed? *
Has Any subsidiary Company been sold or ceased trading? *
Rights issued? *
Is the Company aware of any proposal relating to its acquisition by another company *
Is the Company Public *
Listed on Foreign Stock Exchange *
Total Number of Shareholders *
All holdings representing 15% or more of the Ordinary Share Capital of the Company giving the holder and the percentage held by each. *
Please give details of any change to the list of Directors and Officers given in the Company’s last report and accounts. *
Does the Company or any Director or Officer have Directors and Officers Liability Insurance currently in force? *
Have claims ever been made against any past or present Director or Officer of the Company or its Subsidiaries? *
Any other material Information / Requirement
Cover Details
Limit of indemnity (Cover-A & Cover-B) *
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OICL Office State *
City/Town *
Branch/Office *
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Whether any agent is involved for this proposal?
* If 'NO' is selected, the policy will be issued under code of Development Officer without an Agent.

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