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Home > Quote Forms

Quote Forms


Available Quote Forms

Looking for coverage? Click any of the following links to submit a quote for quick, accurate and affordable rates.

Agents E&O Quick Application
Commercial Crime Application
Commercial Crime Quick Application
Cyber Liability Application
Director's & Officer's Application
Director's & Officer's Quick Application
Employment Practices Liability Application
Lawyers Professional Liability Insurance Application
MGA/Wholesaler Application
Professional Liability Insurance Quote
Punitive Damages Quote
Real Estate Professional Liability

More Information

DOWNLOADABLE APPLICATIONS   

 
Do Not See What You Need?  Call 800-460-6424 
or Email:
insurance@useo.com

RETAIL AGENTS AND BROKERS

Insurance Agents & Brokers writing primarily (50% or more) Property and Casualty

Crop Insurance Agents

Life and Health Agents and Brokers

 

MGA/ MGU / WHOLESALERS / TPA

P & C Application with MGA /Wholesaler Supplement

Third Party Administrators

Life & Health Wholesale Application

Benefit Administrators Application

Claims Adjuster/Appraisers/ Inspection Service

 

Insurance Company  E & O Application

Directors & Officers Application

Employed Practices Liability Application (EPLI)

Cyber Liability / Technology E & O Application

Commercial Crime Application

 

Underwriters Rely on Accurate Applicatons

As a business owner, we know that it is hard to complete an application when you are down to the last minute.  As your broker, we encourage your information to be prepared at least 30 days before your expiration date. The information on your application needs to be as accurate as possible.  As an insurance agent for your clients, you understand how important the application is to secure adequate coverage.

Your E & O carrier is relying on you.  What happens if inaccurate information is provided?  The carrier has a right to cancel your policy back to the effective date of coverage and refund your premium leaving you with no coverage.   Underwriters may understand mistakes from time to time, but they should be innocent mistakes, not misrepresentations of your risk. 

Common Terms on an E & O Application:

NAMED INSUREDS:  Name of the corporate entity to be insured.  If you are an individual, use your licensed name and any trade name you will be using to conduct business. A Corporate Organizational Chart  should be given to your broker with percentages of ownership, managing partner information, or other holding company information that may share an interest in your company.  At all times, your broker should be notified with changes in ownership, mergers and acquisitions, or address change or a additions to the named insured’s on your policy.   Always read your policy for details before you negotiate to purchase a book of business or sell your agency.

LOCATIONS:  Most E & O policies cover your locations automatically.  Locations are identified so Underwriters can understand if you have adequate personnel or if you have any special proof of coverage requirements.  It is always a good idea to prepare an exhibit of locations listing all addresses.

ADMITTED CARRIERS:  Insurance Companies that are “admitted “in the State(s) they write have taken the time and effort to be approved by a State’s Insurance Department.  An Admitted Carrier  is licensed and authorized to do business and must comply with the State’s Insurance Departments Regulations.   You can check with your State’s Department of Insurance Website to find Approved Carriers.  Admitted Carriers file all rates, policy forms and endorsements for approval.  Admitted Carriers are rated by A.M. BEST (www.ambest.com) or Demotech, Inc., (www.demotech.com) or non-rated.  Admitted carriers can also be apart of the Guaranty Fund in the event of carrier insolvency.

NON-ADMITTED CARRIERS:  Insurance Companies are “non-admitted” because the company has elected not to be approved by the State’s Department of Insurance or elected not to comply with filing rates or policy forms.  If a non-admitted carrier becomes insolvent, the State’s Guaranty Fund will not protect unpaid claims.  Non-Admitted Carrier Products are required to charge surplus lines taxes .  Non-Admitted Carriers are rated by A.M. BEST  (www.ambest.com) or Demotech, Inc., (www.demotech.com) or non-rated   Non-Admitted carriers are not a part of a State’s Guaranty Fund.

RATED OR NON-RATED CARRIERS:

“Rated carriers” are defined as financially rated by  A.M. BEST. (www.ambest.com)  An Insurance Company with a financial rating of  B+ or better at the time the risk is placed  is the industry standard. 

Demotech,Inc (www.demotech.com) also rates carriers, however, on most applications for E & O, the question revolves around  A.M. Best financial ratings.

“Non-Rated Carriers” should be looked at closely, but you as the agent, need to be aware of the carriers financial ability  to pay claims.  Many companies may be non-rated including county mutual companies or farm mutual companies  It is important to note that newly formed insurance companies may be in the process of getting a financial rating and thus, are non-rated. 

Regardless if a carrier is Admitted or Non-Admitted, each insurance company you represent  is either rated by A.M. BEST, Demotech, Inc. (www.demotech.com) , or is Non –Rated.  Agents should monitor their carriers ratings for financial stability and ability to pay claims to your insured's.

GOVERNMENT FUNDED PLANS  FOR WINDSTORM/ WORKERS COMPENSATION OR ASSIGNED RISK PLANS- Certain States have funds set up for catastrophic events like windstorm damage from hurricanes.  Funds or  Insurance Associations whether self-funded or guaranteed by the State or Federal Government may or may not be rated.  Check on the website of the fund or plan for information on the financial rating of the fund.  Some plans or funds may not  be covered by the State’s Insurance Guaranty Fund since they are not licensed as an insurance company.  Check your State for details.

RETROACTIVE DATE:  Provision in claims made policies  that defines the date the agency was first insured for coverage for professional services.  This date defines coverage if a claim is made against you or the agency,  If your  first policy began on January 1, 2012, and a claim is served on your agency for acts that occurred before January 1, 2012,  the claim will be denied because you or your agency had no coverage in place at that time. Only claims for wrongful acts occurring after the retroactive date will be covered.

Only claims for wrongful acts occurring after the retroactive date will be covered as long as you have an active policy in place.  Gaps in coverage can also amend the retroactive date.  Why did we just spend two paragraphs on this definition?  The retroactive date is a specific date that should not change.  By changing the Retroactive Date, you are changing coverage.   Please call your broker to discuss any issues or concerns.  Questions are welcome!

PRIOR ACTS DATE OR PRIOR ACTS COVERAGE:

A feature of claims made policies that refers to the “retroactive date”

“RDI “or RETRODATE INCEPTION: The inception date of a claims made policy which is the start date of coverage for a newly formed named insured.  

FULL PRIOR ACTS:  Claims arising from acts, errors or omissions occurring prior to the inception date are covered.  If an E & O carrier uses this term, it means the Named Insured has had E & O coverage in place, uninterrupted for the past five years.

PREMIUM VOLUME:  Premiums for new and renewal business should be on the application.  If you are a new agency, you can estimate premium volume for the next 12 months. 

GROSS COMMISSION INCOME:  Gross income from commissions on new and renewal business before distributing the commission to yourself others.  Sometimes agents can have contingency commission income.  This should be reported on the application also.

NET COMMISSION INCOME: Income retained by the Named  Insured after paying sub-agents.

Other Questions?  Call us Now!

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