The type or description of your business (Accounting Firm, Country Club, Plumber, etc.). If your business type is not listed, please select “Other.”
The full name of your business.
The name of the person completing this request.
Insurance coverage that is not interrupted by gaps in coverage caused by not paying renewal premiums or allowing the policy to lapse.
Includes mistreatment of employees based on race, color, religion, age, sex, disability, pregnancy, national origin, marital status, sexual orientation or other protected class established under federal, state or local laws.
Includes all of your full time, part time, temporary, seasonal and independent contractors.
Coverage for employers against allegations of discrimination, wrongful termination, harassment, and other employment-related claims made by past, present and potential employees.
Allows coverage for claims arising from wrongful acts that took place at any time prior to the inception date of the policy, as long as the claim is first made during the policy period, subject to limitations in the policy such as the exclusion for claims noticed to a prior carrier.
Includes behavior that creates a hostile, intimidating or offensive work environment that interferes with employee performance.
Allows coverage for wrongful acts that occurred after a specified date as long as the claim is first made during the policy period. The retroactive date should match the date the applicant first purchased continuous coverage.
A Retroactive Date that matches the inception date of the policy if no prior policy was purchased.
The dollar amount that must be paid by the insured before the policy will respond to a loss.
Includes customers, vendors or other individuals that your employees interact with in the course of their employment.
Includes mistreatment of Third Parties by insured employees based on race, color, religion, age, sex, disability, pregnancy, national origin, marital status, sexual orientation or other protected classes established under federal, state or local laws.
Includes behavior that creates a hostile, intimidating or offensive work environment to a Third Party.
Allegations that stem from a violation of an employee’s rights to proper pay, including overtime and minimum wage requirements.