Cyber Liability Insurance Quote Request

Step 1 of 3

What is the full legal name of your company?(Required)

What type of entity is your operation?(Required)

What is your name?(Required)

First Last

What is your position in the company?(Required)

Email(Required)

Phone

Address(Required)

Street Address City State ZIP Code

Website

What date did this business start?(Required)

Which class best describes your business?(Required)

Start typing to narrow down selections

Please provide a brief description of your operations.(Required)

Total assets as of most recent fiscal year-end:(Required)

Annual revenues as of most recent fiscal year-end(Required)

Indicate which safeguards you have in place

Up-to-date, active firewall technology(Required)

Yes

Up-to-date, active anti-virus software on all computers, networks, and mobile devices(Required)

Yes

A process in place to regularly download and install patches(Required)

Yes

Backup and recovery procedures in place for all important business and customer data(Required)

Yes

An incident response plan to respond to a network intrusion(Required)

Yes

A disaster recovery plan, business continuity plan, or equivalent to respond to a computer system disruption(Required)

Yes

Controls to ensure the content of media communications and websites are lawful(Required)

Yes

Procedures in place which require service providers with access to the Applicant’s systems or the Applicant’s confidential information to demonstrate adequate network security controls(Required)

Multi-factor authentication for remote access to email and other systems and programs that contain private or sensitive data in bulk(Required)

Yes

N/A

Are you currently compliant with Payment Card Industry Data Security Standards (PCIDSS)?(Required)

Yes

N/A

Are you HIPAA compliant?(Required)

Yes

N/A

Approximately how many individually identifiable records/clients/individuals does your company have on file?(Required)

This applies to all clients, individuals, companies, and employees. If you have a more specific number, please feel free to enter it.

Cyber Liability Insurance Quote Request

Indicate which safeguards you have in place

Indicate whether you encrypt the following private or sensitive data

In the past three years, have you experienced any of the following?