Directors and Officers Insurance for Private Companies

Producer Information

Business or Non-Profit Name

Your Name

First Last

Email Address

Enter Email Confirm Email

We can use this to contact you with questions or send a quote.

Phone Number

Information We Need to Get a Quote

Address

Street Address Address Line 2 City State ZIP Code

For Profit or Non-Profit*

For Profit (Private Company)
Non-Profit
For Profit (Public Company)

Fund Balance ($)

Number of Board Members - VOLUNTEERS

Number of Board Members - PAID (people who are compensated to be the board

Number of Full Time Employees

If you have none, just write "none"

Number of Part Time Employees

If you have none, just write "none"

Total Payroll to all employees (if any)

Please write either an amount or "none"

Description of Operations and any other information that you want to provide

We need a description of the services that your business or non-profit provides.

Does the applicant have any of the following?

Current Insurance (in force)
Prior Claims (Closed)
Open Claims
Negative Fund Balance
Knowledge of a potential incident that may result in a claim

Name of prior carrier, retroactive date, and in force limits

Are you interested in adding Fiduciary Liability?

No
Yes

Fiduciary liability is important if you manage funds any benefits plans, retirement plans, group life insurance, cash plans, or related plans.

If you also want Fiduciary Liability answer this questions: How much money is under management (in 401k or retirement accounts)?

If you manage any benefits, group life, medical expense plans, or pension and retirement plans, you should consider purchasing this coverage.

Limits of insurance that you are requesting

In many cases, you will see several options on the quotes. If available, quotes will include separate limits of coverage for directors and officers insurance and/or employment practices liability insurance.

Do you have an application or loss runs that you want to upload?

Max. file size: 256 MB.

Directors and Officers Insurance for Private Companies

Producer Information

Information We Need to Get a Quote

Get a Quote

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