Cyber Insurance – Shopping Form

Cyber insurance shopping form

We’ll get quotes from multiple carriers for you.

General Information

Entity Name *

Website Domain(s)

Address

City

State

Zip

Industry

Number of employees *

Revenue

Gross Profit / Net Revenue

e-mail *

Anything else you'd like us to know?

Attestation Questions

Within the last 3 years has the entity suffered any cyber incidents resulting in a claim in excess of $25,000? *

Is the entity aware of any circumstances that could give rise to a claim under this policy? *

Upload any relevant items pertaining to incidents, claims, or potential claims.

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How many PII or PHI records does the entity collect, process, store, transmit, or have access to? *

What is the estimated annual volume of payment card transactions (credit cards, debit cards, etc.)? *

Does the entity implement encryption on laptop computers, desktop computers, and other portable media devices?

Does the entity implement encryption on laptop computers, desktop computers, and other portable media devices? *

Does the entity maintain at least weekly backups of all sensitive or otherwise critical data and all critical business systems offline or on a separate network? *

Does the entity 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? *

Within the last 3 years has the entity been subject to any complaints concerning the content of its website, advertising materials, social media, or other publications? *

Does the entity enforce procedures to remove content (including third party content) that may infringe or violate any intellectual property or privacy right? *

Thank you for your request for cyber insurance quotes. We will be in touch with more information very shortly! If you have questions or additional details to share call us at 509-324-0640 or email [email protected].

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