Our "Application" - What information do I need to quote a policy with Coalition?

The US fillable PDF is a full application including signature bundles. This saves your client from needing to submit their signature at the time of binding, streamlining the process from quote to bind.

Any appointed insurance broker can quote and bind a Coalition cyber insurance or technology errors & omissions policy online in under four minutes. During this process, you'll be asked a few simple questions about the insured (see below), with little-to-no preparation required. Need to change an answer later on? No problem. Responses can be changed at any time. It’s literally as easy as riding a bicycle. 

All the same, if you want to be prepared (some of us were Boy Scouts too), here’s the information to have on hand:

• Company Name (i.e., the named insured(s))

• Business Domain(s) (i.e. website, email, and other domains)

• Industry

• Number of employees (asked in ranges)

• Estimated annual revenue, projected for the next 12 months (gross revenue or net revenue may also be requested for certain industries)

• US or Canadian headquarters address

Cyber insurance Questions

• Question 1: Within the last 3 years, has company suffered a cyber incident resulting in a claim in excess of $25,000? (Yes/No answer)

• Question 2: Is company aware of any circumstances that could give rise to a claim under this insurance policy? (Yes/No answer)

• Question 3: Does company implement encryption on laptop computers, desktop computers, and other portable media devices? (Yes/No/Sometimes answer)

• Question 4: Does company collect, process, store, transmit, or have access to any Payment Card Information PCI*, PII**, or PHI*** other than employees of company?

• If Yes to #4, then two questions: What is the estimated annual volume of payment card transactions (credit cards, debit cards, etc.)? How many PII** or PHI*** records does company collect, process, store, transmit, or have access to?

• Both answers are ranges: None / <100K / 100K-500K; 500K - 1M / over 1M needs number

• Please select an effective date for company's policy.

Additional questions for cyber insurance may be asked based upon the coverages selected or the industry of the company, such as:

• Within the last 3 years, has company been subject to any complaints concerning the content of its website, advertising materials, social media, or other publications? (Yes/No answer)

• Does company enforce procedures to remove content (including third party content) that may infringe or violate any intellectual property or privacy right? (Yes/No answer)

• Does company maintain at least weekly backups of all sensitive or otherwise critical data and all critical business systems offline or on a separate network? (Yes/No answer)

• For which of the following services do you enforce Multi-Factor Authentication (MFA)?

  • Email - (Yes/No answer)

  • Virtual Private Network (VPN), Remote Desktop Protocol (RDP), RDWeb, RD Gateway, or other remote access (Yes, No or N/A - No Remote Access Allowed

  • Network / cloud administration or other privileged user accounts (Yes, No or On administrative accounts and all cloud services where supported)

• Does company require a secondary means of communication to validate the authenticity of funds transfers (ACH, wire, etc.) requests before processing a request in excess of $25,000? (Yes/No answer)

Technology E&O questions
(can be added to any qualifying cyber policy and only needs to be answered if Technology E&O is quoted)

• Question 1: Within the last 3 years has the company been subject to a dispute or claim arising from a technology error or omission? (Yes/No answer)

• Question 1a (only appears if Yes answered on question #1): Please provide detail (text box)
  
   

• Question 2: Which of these services does [company] provide? (Select all that apply) - (drop down menu per below).   

  • SOFTWARE
    • Software Product Provider (own) including SaaS
      This may include licensing, onsite installation or SaaS provision, maintenance, version upgrade and training.
    • Software Product Provider (third party) including SaaS.
      This may include licensing, onsite installation or SaaS provision, maintenance, version upgrade and training.
    • Software Implementation (own or third party package)
      This may include software and hardware requirements definition, business requirements definition, customization, hardware provision, installation and configuration, software installation and configuration, SaaS provision, testing, training, ongoing maintenance and version upgrade.
    • Software Development  
      This may include requirements definition, bespoke software development, installation or SaaS provision, testing, training, ongoing maintenance and version upgrade
    • Software Game Development
      This includes the development of a software game or any part of a software game for any platorm including mobile, console, PC or other
    • Software Game Publishing
      This includes the concept creation and definition, inhouse or outsourced development of games for distribution and sale under your own brand for any platorm including mobile, console, PC or other.
    • Software Testing Services
      The outsourced testing of new software code for third party software developers or in-house corporate developers
    • Software Package Training Services
      Provision of training services to end users for third party packaged software.
  • HARDWARE
    • Computer Hardware Manufacture and Assembly (third party)
      Outsourced contract manufacture and assembly of third party designed and branded computer hardware or peripherals
    • Computer Hardware Assembly (Own brand)
      Assembly and sale of own brand computer hardware or peripherals from third party supplied components.
    • Computer Hardware Design and Manufacture (own brand)
      Design of original computer hardware or peripherals including third party components, manufacture (whether outsourced or not), and sale under your own brand.
    • Computer Hardware Sales
      The sale and distribution of computer hardware and peripherals.
    • Robotics Hardware Device Manufacture
      Design and/or manufacture and/or distribution of proprietary robotic technology   
    • Robotics Hardware Device Sales
      Sale of third party robotic technology devices.  
  • OUTSOURCED SERVICES
    • Colocation/Data Center Services
      Operation of physical data centers for the housing of third party clients’ computer and telecommunication systems.
    • Managed Service Provider (MSP)
      Provision of remote outsourced IT business services including network infrastructure and application management, administration, hosting, helpdesk support and maintenance.
    • Managed Security Service Provider (MSSP)
      Provision of remote outsourced IT security management services including security device and application management and monitoring, provision of outsourced security operations center.
    • IaaS and PaaS Cloud Computing Services
      Provision of cloud infrastructure including network, servers, operating systems and storage.
    • Web Hosting                                                                                                                                                 Domain name registration, provision of hosted email services, website design tools/design services and website hosting.
    • Payment Processing                                                                                                                                          The provision of any transaction processing services via point of sale (POS), online or mobile including payment processing, payment service provision, payment gateway, POS system provider, for all forms of payment including credit card, debit card, prepaid card, digital wallet.
• CRYPTOCURRENCY
  • Cryptocurrency Exchange
    Provision of a platform for the holding and trading of cryptocurrencies whether as a centralized, decentralized or a hybrid exchange.
  • Cryptocurrency Payment Gateway
    Payment routing and settlement between merchant and customer including conversion to fiat currency.
  • Cryptocurrency Miner
    The utilization of computing resources to create and acquire new cryptocurrency tokens.
  • Initial Coin Offering
    The creation and distribution of new cryptocurrency tokens to investors.
• IT CONSULTANCY SERVICES
  • IT Consultancy
    The provision of IT related advisory services including strategic consultancy, project management and fulfillment of interim IT roles on a contract basis.
  • IT Security Consultancy
    The provision of advisory services related to IT security including, security audit, security research, penetration testing, vulnerability scanning, incident response planning, incident response management, IT forensic investigation services, IT security training services.
  • IT Staffing
    The provision of IT personnel on a temporary or permanent basis
  • Web Services 
    The design and/or development of websites and online content, search engine optimisation, social media strategy, digital marketing.
• TELECOMMUNICATION
  • Telecommunication service provider 
    Provision of telecommunication and internet services to consumers and/or business utilizing your own telecoms network infrastructure.
  • Virtual Network Operator
    Provision of telecommunication and internet services to consumers and/or business utilizing the telecoms network infrastructure of a third party.
• OTHER
  • Non-Technology Activities (No Tech E&O Coverage Applies)

• Question 2a : Estimate the percentage of [company]'s revenue derived from each activity (optional - can be left blank or, for risks with multiple activities, total must add up to 100%)

• Question 3: What is the average value of [company]'s contracts? (currency field)

• Question 4: Provide the value and duration (in months) of [company]’s three largest contracts.  For subscriptions, provide the annual value and enter a duration of 12 months.(Optional grid to fill in profile information for the largest clients)

• Question 5: How does [company] limit its liability in its standard contracts? (select from options below)

  • As % of Contract Value

  • As % of Annual Fees

  • Fixed amount

  • No limit

  • Don’t Know

• Question 5a (only appears if % of contract value or % of annual fees selected in question #5): Please specific percentage  (select from ranges <100%, 100-125%, 126-150%, >150%, Don't Know) 

• Question 5b (only appears if fixed amount selected in question 5): Specify Amount (currency field)

• Question 6: What proportion of [company]'s contracts are subject to its standard contract terms? (select from range)

  • <10%
  • 11-25%
  • 26-50%
  • 51-75%
  • 76-100%
  • Don’t Know

* PCI = Payment Card Information

** PII = Personally Identifiable Information

*** PHI = Protected or Personal Health Information