Professional Indemnity Self Assessment Sheet
      Introduction and Overview
      AFS licensees that deal with Retail Clients are required to have adequate compensation arrangements in place. AFS Licensees can meet this requirement by maintaining adequate
      Professional Indemnity (P.I.) coverage. This sheet is designed to be used by AFS Licensees who operate as Insurance Brokers and use P.I. to meet their compensation obligations.
      It is up to the AFS Licensee to assess whether this model and the underlying assumptions within it are appropriate to the circumstances of the AFS Licensee. 
      Tips on using the Self Assessment Sheet
      All cells highlighted in Yellow must be answered for the Model to be effective, enter zero's where applicable. Data entry cells change from Yellow to Beige when completed
      All Comment cells that display in Red indicate that the information entered suggests the proposed P.I. cover does not meet the requirements
      All Comment cells that display in Green indicate that that the information entered suggests the proposed P.I. cover does meet the requirements                                          Required
      An Overall Assessment is only calculated once all data entry has been completed.  Use the "Enter", "Tab", "Up", "Down" keys to move between required fields.
      The reference to "Retail Client" means an individual/small business that is buying Home/Motor/P.A./Pleasurecraft as per the Corporations Act (The Act).
      The completed Sheet (with appropriate file name) should be filed in your Compliance Folder on your Intranet or within your Document Scanning system.
      Section 1  - Licensee and P.I. Coverage Details                                                          Comments/Explanations
      AFS Licensee Name                                                                                        Confirms the identity of the firm undergoing the Self Assessment
      AFS Licence No.                                                                                          Confirms the identity of the firm undergoing the Self Assessment
      Start date of P.I. Cover                                                                                 Validates the cover requirements during the Transition Phases
      Name of P.I. Scheme / Facility of cover                                                                                                                                                 y
      Proposed Sum Insured of P.I. Cover                                                                                                                                                      y
      Proposed Excess of P.I. Cover
                                                                                                               Name of person who has completed/verified the information entered into the 
      Assessment sheet completed by                                                                            sheet.  Should be a Responsible Manager or Compliance Officer.
      Date that sheet was completed                                                                            Date that sheet was completed
      Section 2 - Overall Assessment
      Please answer all questions on sheet highlighted in bright yellow to generate Overall Assessment                                                                                    ###
      Please answer all questions on sheet highlighted in bright yellow to generate Overall Assessment                                                                                    ###
      Please answer all questions on sheet highlighted in bright yellow to generate Overall Assessment                                                                                    ###
      Section 3 - Assessment Summary
                                                                                                               This is the minimum based on the RG126 requirement of at least $2m cover 
      Minimum Sum Insured Required                                                                             or the income of your Retail Clients to a maximum of at least $20M.
      Overall Risk Loading compared to Base Retail Client                                                      This is a subjective assessment of the additional cover required to meet the 
      Income                                                                                                   risk profile of the business based on the information in the model. 
                                                                                                               This a Compliance rating based on the answers provided by the coverage and 
      P.I. Policy Coverage / Exclusions Compliance Level                                                       exclusions of the P.I. policy.
      Cash resources available to the business                                                                 Value of funds available for potential excesses and uninsured losses.
      Estimate of internal financial resources required to                                                     This is an assessment of the funds required by the business to meet expected 
      meet uninsured losses and excesses                                                                       excesses and uninsured losses (plus a contingency loading).
            13741_assessment_tool.xls                                                         07/07/2022                                                                              1 of 9
                                                                     Professional Indemnity Self Assessment Sheet
      Surplus business funds available to meet uninsured                                                      This is the result of subtracting the internal Financial resources required to 
      losses and excess                                                                                       meet uninsured losses and excess from the Net Current Assets
            13741_assessment_tool.xls                                                        07/07/2022                                                                            2 of 9
                                                                       Professional Indemnity Self Assessment Sheet
      Section 4 - Quantitative Risk Assessment Information
      Income Details
      What was the total Business Income for last financial                                                       This figure is used to calculate the level of Retail Client Income, Client 
      year (As per annual audited accounts)?                                                                      Numbers / Claim No's and number of representatives are driven by income.
      What is the forecast Total Business Income for current                                                      This figure is used to calculate the level of Retail Client Income, Client 
      financial year?                                                              $35,000                        Numbers / Claim No's and number of representatives are driven by income.
      Percentage of Total Business Income Generated from Retail Clients (As per Corps Act definition)
      What was the Retail Client percentage of last financial 
      year income above?                                                                                          This figure is used to calculate the level of Retail Client Income
      What is the expected Retail Client percentage of 
      current financial year income above?                                                                        This figure is used to calculate the level of Retail Client Income
      Retail Client Income Estimate
      last Financial Year Estimate                                                    $0                          RG126 requires your P.I. Sum Insured to at least match your income from 
                                                                                                                  retail clients, with a minimum of $2M up to a maximum of $20M.  The system 
      Current Financial Year Estimate                                                 $0                          uses the greater of last years income or the forecast income.
      Does the proposed P.I. cover include both Retail and                                                        If the P.I, cover includes cover for Wholesale Clients the model adjusts for the 
      Wholesale client coverage?                                                                                  risk of Wholesale Clients exhausting the P.I. cover.
      What percentage of the P.I. premium is generated for                                                        Any such coverage provided to non AFS Licence activities reduces the 
      non AFS Licence activities?                                                                                 potential coverage available for Retail Clients 
      What is the percentage of Retail Income that is 
      generated from a particular source / scheme / facility /                                                    This is used as an indicator of the level of risk to multiple P.I. claims from the 
      specialised product etc?                                                                                    one event that exists in your business.
      Section 5 - Risk Assessment of Business Resources that may be required to meet excesses/uninsured losses
      What is the value of Total Current Assets from the last                                                     This is used to calculate the potential cash assets available to meet potential 
      set of audited accounts?                                                                                    excesses and uninsured losses
      What is the value of Total Current Liabilities from the                                                     This is used to calculate the potential cash assets available to meet potential 
      last set of audited accounts?                                                                               excesses and uninsured losses
      What is the value of unused overdrafts etc available to                                                     This is used to calculate the potential cash assets available to meet potential 
      the business?                                                                                               excesses and uninsured losses
      What is the expected cash flows (Net profit After Tax)                                                      This is used to calculate the potential cash assets available to meet potential 
      from business activities for the current financial year?                                                    excesses and uninsured losses
      What is the value of loans available from shareholders                                                      This is used to calculate the potential cash assets available to meet potential 
      etc. if required.                                                                                           excesses and uninsured losses
            13741_assessment_tool.xls                                                           07/07/2022                                                                               3 of 9
                                  Professional Indemnity Self Assessment Sheet
   Value of Cash or equivalents potentially available to 
   meet uninsured losses.                 $0           Value of funds available for potential excesses and uninsured losses.
      13741_assessment_tool.xls               07/07/2022                                  4 of 9