Cyber Insurance Application

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Cyber Insurance Application

Insgroup has developed cyber coverage you can bind today in just a few clicks. As a leader in insurance and technology, Insgroup leverages big data and industry-specific knowledge to limit the amount of information we need from you in order to quote.

Cyber Insurance Application

Name

First Last

Phone

Policy Effective Date

MM slash DD slash YYYY

The policy limit is 12 months

What is your company's website?

Account Details

Prior Fiscal Year Global Revenue

% Domestic Revenue

Projected Next Fiscal Revenues (Optional)

Do you know the number of protected records?

Number of Protected Records

*Sensitive records at risk in the event of a cyber incident*

Does your company currently or will the your company potentially operate as any of the following?

Accreditation Service Provider

Adult Content Provider

Credit Bureau

Cryptocurrency Exchange

Data Aggregator/Broker/Warehouse

Direct Marketer

Gambling

Manufacturer of Life Safety Products/Software

Media Production

Payment Processor

Peer to Peer File Sharing

Social Media

Surveillance

Third Party Claims Administrator

N/A

Or does your company derive more than 50% of its revenue from technology products and services(e.g software, electronics, telecom)?

Loss History

Within the past 3 years, has your company had any actual or potential professional, E&O, media, or cyber incidents or claims?

Or is your company aware of any notices, suits, facts or circumstances that could reasonably be expected to give rise to a professional , E&O, media, or cyber incident or claim?

Underwriting Questions

Does your company accept payment card(credit or debit card) transactions?

Does your company deal with protected health information as defined be HIPPA?

Which of the following IT security controls does your company have in place?

Antivirus and Firewalls

Encryption of Sensitive Data

Encryption of Mobile Computing Devices

Critical Software Patching Procedures

Critical Data Backup and Recovery

Formal Cyber Incident Response Plan

Are there any scheduled providers to add for Contingent Business Income?

Coverage Level Questions

Does your company intend to purchase E&O and/or media coverage on a separate and distinct policy? (e.g. with a separate set of limits, or with another carrier?)

Has your company obtained legal review of its use of trademarks, including domain names?

What's New?

Stay up-to-date on the latest happenings at Insgroup and within the industry.

Sep 27 - Employer’s Balancing Act: Part 2 | Solutions and Strategies to Help Equalize Cost While Offering In-Demand Benefits Sep 08 - Employer’s Balancing Act: Part 1 | Finding Your Equilibrium Managing Costs While Offering In-Demand Benefits Aug 28 - Tips To Navigate a Homeowners Claim With Confidence

Resources

Gain insight through our resources on a variety of services and topics.

2021 Private Risk Management Market Mid-Year Outlook

Inflation-Adjusted Limits for HSA’s and HDHP’s

2021 Construction Industry Mid-Year Market Update

2021 Employee Benefits Market Outlook

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Toll Free: (800) 713-4711
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Cyber Insurance Application

Cyber Insurance Application

Account Details

Loss History

Underwriting Questions

Which of the following IT security controls does your company have in place?

Coverage Level Questions

What's New?

Resources

Our Location