AIC Online Renewal

Statement of Fact

Allianz Plc Pharmacy Professional Indemnity Renewal 2025.
Simply complete all of the fields below to confirm your renewal for the forthcoming year.

Account
Personal
Confirmation
Payment Method
Summary
Pay

Account Information:

Step 1 - 6

Broker Number: *

PIN: *

Pharmacy Information:

Step 2 - 6

Full Name:

Address:

Contact Tel. No.:

Email:

Arachas Reference:

Confirmation:

Step 3 - 6

In order to confirm your renewal, we will require you to declare your actual turnover figure, followed by payment of your renewal premium. This will form the basis of your contract of insurance. This information has been requested from all policyholders under the scheme, so that insurers can apply the new rating structure with effect from next renewal date, which is 1^st June 2025.

While we understand the policyholders’ concerns, the information submitted to insurer by scheme members will of course be treated in the strictest of confidence and the detail will not be shared with any third parties.

Declared Pharmacy Turnover Figure (Inclusive of VAT): *

Please provide your turnover as a valid number (e.g. 10000 no commas, no leading zeros)

Your Total to pay: € 0

Total Payable is inclusive of 5% government levy & administration fee of €90.00

I accept and confirm that the answers and statements provided in this declaration have, after enquiry, been provided honestly and with reasonable care. I agree that declaration, together with any other information supplied, shall form the basis of any contract of insurance effected thereon. I undertake to inform the insurer, as soon as reasonably possible, if any of the answers or information provided is inaccurate or has changed beyond what was reasonably contemplated when the contract of insurance was concluded (“alteration of risk”).

You will find our Terms of Business documents here.
Please tick the following box to confirm that you have read and accept our terms of business.

You have to agree with the website privacy policy

As an Arachas customer, we may occasionally reach out to share offers and updates about our products using the contact information we have on file. If you do not wish to be contacted, you can opt out by ticking this box.

Payment Method:

Step 4 - 6

Choose payment method: *

Summary:

Step 5 - 6

After you press the SUBMIT button below, your information will be submitted and you will receive a confirmation of your request for cover to your email address listed below.

Your Cover Details

Email:

Contact Name:

Payment Method:

PAY: €

Statement of Fact

Account Information:

Step 1 - 6

Pharmacy Information:

Step 2 - 6

Confirmation:

Step 3 - 6

Payment Method:

Step 4 - 6

Summary:

Step 5 - 6

Payment:

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First Name	Last Name
Phone Number *	Email