Welcome to GB

New Client – Questionnaire

To ensure your transition to Gallagher Bassett is as smooth as possible please complete the below questionnaire. Your answers will assist us to correctly set up your account and ensure the appropriate measures are in place to manage your claims.

If you are having difficulty completing this form or would like immediate assistance, contact our general insurance team on xxxx.

The fields marked with an asterisk (*) below must be completed for this form to be submitted.