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Cyber Liability Insurance Premium Indication
Cyber Liability Insurance Premium Indication
Complete this short application to get multiple cyber liability insurance quotes.
Step
1
of
3
33%
REQUESTED COVERAGE
1. GENERAL DETAILS
Limit
(Required)
SELECT
$250,000
$500,000
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
Retention
(Required)
SELECT
$1,000
$2,500
$5,000
$10,000
You can add additional limits and retentions later.
Initial quotes presume standard business and cyber hygiene practices. These presumptions can later be adjusted by you, and may affect coverage and pricing.
Prior Cyber Claims
(Required)
On behalf of the company I'm applying for cyber insurance, I confirm that this company has NOT been involved in any cyber related claims in the past five years
Yes
2. COMPANY DETAILS
Company name
(Required)
Website
(Required)
Operations
(Required)
Describe company's services, products and operations. You can use NAICS code if known.
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Billing address same as physical address
Yes
Billing address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
(Required)
First
Last
Contact Email
(Required)
we guarantee zero spam and no marketing emails.
Contact Phone
(Required)
we guarantee zero spam and no marketing calls.
Annual revenue of last fiscal year
(Required)
Estimated annual revenue for upcoming fiscal year
(Required)
Does the applicant currently carry a standalone cyber policy?
(Required)
Yes
No
Expiration date
(Required)
MM slash DD slash YYYY
Multi-factor authentication (MFA)
(Required)
Does the Applicant have multi-factor authentication enforced on email access, remote access & network administration? Choosing "I don't know" won't change the presumptions. You will still receive all relevant quotes regardless of carrier MFA requirements.
Yes
No
I don't know
EASYFIRM
Answer a few additional questions and get up to eight bindable quotes! Each question you answer will "firm up" the quotes delivered.
1. Number of company employees
(Required)
1 - 25
26 - 50
51 - 250
251 - 500
501 - 1000
More than 1000
2. How many PII, PHI or PCI records does the applicant collect, process, store, transmit, or have access to?
(Required)
Personally Identifiable Information (PII), Payment Card Industry (PCI) data, and Protected Health Information (PHI)
No Records
< 100K
100K - 250K
250K - 500K
500K - 1M
> 1M
3. How many biometric information records or data (i.e fingerprints, retinal scans, etc.) does the applicant collect, process, store, transmit, or have access to that can be used to uniquely identify a person?
(Required)
No Records
< 100K
100K - 250K
250K - 500K
500K - 1M
> 1M
4. Does the Applicant keep offline backups for all critical data that are disconnected from its network or store backups with a cloud service provider?
(Required)
Yes
No
5. Does the applicant implement encryption on laptop computers, desktop computers, and other portable media devices for all sensitive information?
(Required)
Yes
No
6. What is the estimated annual volume of payment card transactions (credit cards, debit cards, etc.)?
(Required)
No payment card transactions
< 100K
100K - 500K
500K - 1M
> 1M
7. Does the applicant require a secondary means of communication to validate the authenticity of funds transfers (ACH, wire, etc.) requests by at least 2 employees?
(Required)
Yes
No
8. Does the applicant enforce procedures to remove content (including third party content) that may infringe or violate any intellectual property or privacy right?
(Required)
Yes
No