Technology Errors & Omissions Liability Renewal-FAILSAFE®

Renewing Your Policy

Please tell us some information about the applicant and coverage selections before submitting your renewal application. Keep in mind that:

  • All answers are required unless they are listed as "optional".
  • The words "applicant", "you", and "your" refer to the person or entity who is requesting insurance.
NOTICE: THIS POLICY CONTAINS CLAIMS MADE COVERAGE. EXCEPT AS OTHERWISE SPECIFIED: COVERAGE APPLIES ONLY TO A CLAIM FIRST MADE AGAINST THE INSUREDS DURING THE POLICY PERIOD AND WHICH HAS BEEN REPORTED TO THE INSURER IN ACCORDANCE WITH THE APPLICABLE NOTICE PROVISIONS. COVERAGE IS SUBJECT TO THE INSURED'S PAYMENT OF THE APPLICABLE RETENTION. PAYMENTS OF DEFENSE COSTS ARE SUBJECT TO, AND REDUCE, THE AVAILABLE LIMIT OF LIABILITY. PLEASE READ THE POLICY CAREFULLY AND DISCUSS THE COVERAGE WITH YOUR INSURANCE AGENT OR BROKER.

Your Contact Information

Please tell us some basics about your business and current policy.

Screening Questions

Is the Applicant or those that purchase their software, products or services involved in any of the following: social networks, search engines, gambling technology, distribution of unsolicited advertising or content, any utilities infrastructure (not related to telecommunications), use of obscenity or pornography, financial technology directly involved in funds transfer or trading.
   
Is the applicant or those that purchase their software, products or services involved in any of the below? Please select all that apply.

Your Coverage Information

Now tell us some details about your business and the coverage you'd like.
You may need to send some additional information if you request limits of $2M / $2M or more. We'll let you know if we need anything.

Financials

Now tell us about your revenue and expenses.
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Your Intellectual Property Procedures

Other than advertising the Applicant's own product, does the Applicant publish original works or content, including for third parties (eg: media, software, gaming)?
   

Your Subsidiaries, Mergers & Acquisitions

Within the past 24 months, has the Applicant gone through any merger or acquisition activities, sold any assets or been involved in similar transaction(s)?
   
Does the Applicant have any subsidiaries or foreign locations?
   

Your Customers and Contracts

Please tell us about your customers and contractual relationships that you may have with them.
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Your Information Security Procedures

Do the Applicant's products and/or services perform any of the security functions below on behalf of third parties? Select all that apply
Which of the following management controls does the Applicant have in place?
Does the Applicant handle personally identifiable information (PII) and/or protected health information (PHI) of third parties?
   
Does the Applicant use any of the following technical measures, devices, or tools and techniques to prevent unauthorized access, modifications, or corruption of their network, laptops, mobile devices, data storage etc? Select all that apply.
APPLICANT STATEMENT:
I, being duly authorized, have read the above application and declare to the best of my knowledge and belief all of the foregoing statements are true, and that these statements are offered as an inducement to the Company to issue the policy for which I am applying. (Kansas: This does not constitute a warranty).



First State Insurance Company (N/A in MA) New England Reinsurance Corporation (N/A in MA)
Hartford Accident and Indemnity Company Nutmeg Insurance Company (N/A in MA)
Hartford Casualty Insurance Company Omni Indemnity Company (N/A in MA)
Hartford Fire Insurance Company Omni Insurance Company (N/A in MA)
Hartford Insurance Company of Illinois (N/A in MA) Pacific Insurance Company, Limited (N/A in MA)
Hartford Insurance Company of the Midwest Property and Casualty Insurance Company of Hartford
Hartford Insurance Company of the Southeast (N/A in MA) Sentinel Insurance Company, Ltd.
Hartford Lloyd's Insurance Company (N/A in MA) Trumbull Insurance Company (N/A in MA)
Hartford Underwriters Insurance Company Twin City Fire Insurance Company
New England Insurance Company (N/A in MA)


To complete the FailSafe MEGA® Renewal Application and submit via mail, please see below: If the Applicant is domiciled in Delaware, Florida, Illinois, Maine, New York, or Vermont please select and complete the state specific New Business FailSafe® MEGA Application. If the Applicant is domiciled in any state other than those listed above please select and complete the Countrywide New Business FailSafe® MEGA Application