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Please view this form as a helpful risk management assessment.

 

Completing it thoroughly ensures we secure the best possible terms, pricing, and coverage for your specific needs.

 

Important Program Notes:

  • Completeness Matters: Fill out as much information as possible. Mark non-applicable sections as "N/A" and use the comments section for any needed clarification.

  • Existing Applications: If you have a recently completed similar application, we may be able to review it in lieu of this form. However, up-to-date details always yield better underwriter terms. send existing applications and policies to  e-contact@TechRISKS.com

  • Package Bundling: We offer comprehensive package options across E&O, Cyber, General Liability, Property, Crime, Employment Practices Liability (EPLI), Umbrella, and competitive Workers' Compensation. Completing all sections helps us unlock these bundle discounts.

  • Complementary Assessments: We provide free network security scans and risk assessments for your firm and your clients. We can also provide tailored Cyber Insurance options for your clientele upon request.                                    Client portal: https://www.techrisks.com/cyber-insurance

Get a Quote today

Do you provide managed services or managed security services?
Yes
No
Do you provide third parties with social networks, fintech, or infrastructure services?
Yes
No
Do you distribute Unsolicited Advertising or Content?
Yes
No
Does your business involve obscenity, pornography, or interactions with minors?
Yes
No
Do you currently maintain Errors & Omissions insurance?
Yes
No
Does a qualified attorney approve all of your contracts?
Yes
No
In your contract do you always Cap your liability for damages?
Yes
No
Do you require Require legal counsel review if deviating from standard contract or MSA?
Yes
No
Do you have a Written quality control program in place? if no, techrisks.com can provide you one.
Yes
No
Have you gone through any merger, acquisition, sale of any assets or other similar transaction within the past 24 months?
Yes
No
Do you have any subsidiaries or foreign locations?
Yes
No
Has the applicant been involved in any layoffs or , furloughs within the past six months or does the applicant have any plans for the same within the next six months ?
Yes
No
Has the applicant in the last 12 months completed or is the applicant anticipating in the next 12 months any: closings, consolidations, or divestments of any branch, location, office, chapter or Subsidiary?
Yes
No
Does the applicant have an employee stock ownership plan (ESOP)?
Yes
No
Staff & Services: Do you perform any of the following for third parties: online tracking, data aggregation, data mining, gaming or provide products or services that are specifically intended to enable others to engage in cryptocurrency mining, exchange?
Yes
No
Do your products or any of your services perform the following security functions for third parties? Select all that apply.
Yes
No
Do your products or any of your services perform the following security functions for third parties? Select all that apply.
Do you have custody of Personal Health Information (PHI) of third parties?
Yes
No
Unknown

PHI is Any "individually identifiable" health data, such as medical records, lab results, insurance billing details, or even just a patient's name linked to a diagnosis.

Are you responsible for collecting, storing, processing, safeguarding, or any other activity involving the personal information of residents of foreign countries?
Yes
No
How many people’s non-public personal information (NPI) do you collect, store, process, or otherwise handle?
Information Security Do you back up mission critical data regularly, routinely store recent backups offline, and ensure your backups are well isolated from threats against your production systems?
Yes
No
How often do you implement system security updates or patches? (Select one)
Do you have administrative access to your customers' networks?
Yes
No
Unknown
Do you encrypt all electronic information that leaves your physical control (laptops, mobile devices, storage, etc.), using strong encryption and keys so that only you can decrypt it?
Yes
No
Unknown
Do you use technical measures, devices or tools & techniques including: firewalls, anti-virus, passwords/authentication, to preclude unauthorized corruption of your network, including endpoints & sensitive assets within the network?
Yes
No
Is Remote Desktop Protocol disabled in your network? (typically, yes for MSP)
Yes
No
Do you use any expired or unsupported operating systems or applications?
Yes
No
Do you publish original works or content, including software, media, gaming or other content?
Yes
No
Unknown
Building Construction Type:
Is this building sprinklered?
Yes
No
Do Employees drive for work related reasons?
Yes
No
Does your company own any vehicles?
Yes
No

Claims, Loss History & Prior Knowledge

During the past five years, have you experienced or become aware of any of the following?

• Claims, lawsuits, demands, potential claims, or circumstances that could reasonably give rise to a claim


• Complaints involving errors, non-performance, late delivery, or failure of products or services


• Customers withholding payment or requesting refunds due to problems with products or services


• Regulatory investigations, citations, or proceedings


• Security breaches, privacy incidents, vulnerabilities, defamation, or intellectual property infringement


• Any other matter that has been or could have been reported under E&O, Cyber, or Media Liability insurance

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