Image

Privacy Protection Policy

NOTICE:  THIS POLICY CONTAINS ONE OR MORE COVERAGES.  CERTAIN COVERAGES ARE LIMITED TO LIABILITY FOR CLAIMS THAT ARE FIRST MADE AGAINST YOU AND NOTIFIED TO US DURING THE POLICY PERIOD AS REQUIRED.  CLAIM EXPENSES SHALL REDUCE THE APPLICABLE LIMITS OF LIABILITY AND ARE SUBJECT TO THE APPLICABLE RETENTION(S). TERMS THAT APPEAR IN BOLD FACE TYPE HAVE SPECIAL MEANINGS.  SEE THE DEFINITIONS FOR MORE INFORMATION. PLEASE READ THIS POLICY CAREFULLY.

INSURING AGREEMENTs A,B,C,D,E,F OF THE POLICY PROVIDES COVERAGE ON AN INCIDENT DISCOVERED AND REPORTED BASIS; COVERAGE UNDER SUCH INSURING AGREEMENT APPLIES ONLY TO INCIDENTS FIRST DISCOVERED BY THE INSURED AND REPORTED TO THE UNDERWRITERS DURING THE POLICY PERIOD.

A.  Privacy Liability (Including Employee Privacy)

Coverage for amounts the Insured is legally obligated to pay as damages and claims expenses arising out of privacy breach or breach of privacy regulations, including a breach of a customer, client or employee’s sensitive personal or corporate information.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $500,000    Option 2: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $500,000    Option 2:  $1,000,000

 

*SIR $2,500 for both options

B. Privacy Regulatory Claims Coverage

B. Privacy Regulatory Claims Coverage

Coverage for defense expenses and regulatory fines and penalties (including consumer redress funds) incurred as a result of an actual or alleged breach of privacy regulations.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)    

Option 1: $500,000    Option 2: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $500,000    Option 2:  $1,000,000

*SIR $2,500 for both options

C. Security Breach Response Coverage

B. Privacy Regulatory Claims Coverage

Coverage for defense expenses and regulatory fines and penalties (including consumer redress funds) incurred as a result of an actual or alleged breach of privacy regulations Coverage for defense expenses and regulatory fines and penalties (including consumer redress funds) incurred as a result of an actual or alleged breach of privacy regulations.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $500,000    Option 2: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $500,000    Option 2:  $1,000,000

*SIR $2,500 for both options

D. Security Liability 

B. Privacy Regulatory Claims Coverage

Coverage for amounts the Insured is legally obligated to pay as damages and claims expenses arising out of a failure of computer and network security which results in the inability of authorized parties to access the Insured’s network, the theft or damage to data stored on the network, the failure to prevent transmission of malicious code or participation in DDoS attacks.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $500,000    Option 2: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $500,000    Option 2:  $1,000,000

*SIR $2,500 for both options

E. Multimedia Liability 

B. Privacy Regulatory Claims Coverage

Coverage for amounts the Insured is legally obligated to pay as damages and claims expenses arising out of any copyright or trademark infringement, libel, slander,  defamation, plagiarism, invasion of privacy or liability with respect to media content of any nature released by the Insured.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $500,000    Option 2: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $500,000    Option 2:  $1,000,000

*SIR $2,500 for both options

Additional Coverage: Cyber Extortion Coverage Extension

B. Privacy Regulatory Claims Coverage

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1 and 2: $50,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1 and 2: $50,000

 

*Each Cyber Extortion Threat SIR $2,500 for both options

 

Please click on "> Authorized Officer" to open section

Authorized Officer

The officer of the Applicant that is designated to receive any and all notices from the Insurer or its authorized representative(s) concerning this insurance.

 

Please click on "> Breach Response Contact" to open section

Breach Response Contact

You or the employee of the Applicant that is designated to manage a response, including consumer notification, in response to a data breach event.

Questions about Exposure Base

 

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Risks over 50 employees and/or $10,000,000 in revenues and/or non-approved business classifications are not eligible for automated calculation. Please complete the questions and submit this form for special  underwriting. Underwriters may offer alternative attachment points and different rates. You may be requested to provide additional information. 

 

Preview of your Premium Options:

You will be given the chance to choose the option you want later in the application.

 

Option 1 (Limit $500,000)

Option 2 (Limit $1,000,000)

Questions about Information Security and Privacy Controls

1. Do you use commercially available Firewall protection and Anti-Virus Protection, with regular updates and patch management?   Do you  terminate all associated computer access and user accounts as part of the regular exit process when an employee leaves the company?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

2. Do you perform regular backups of your electronic data, preferably daily and store either online or offsite?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

3. Do you process or store credit card information (where this is not outsourced to a third party that accepts full responsibility for Payment Card Industry (PCI) compliance)?

3A. Have you been certified as being PCI compliant within the last 12 months, or have successfully completed a self-assessment audit

3B. How many credit cards do you process annually?    

 3C. Do you have more than 100,000 (PII) personally identifiable information records?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

4. Do you handle medical records or Protected Health Information (PHI),

4A. Have you conducted a review of the business to ensure compliance with all relevant HIPAA legislation?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

4B. Do you ensure that all PHI transmitted over open networks and/or stored on portable devices is encrypted.

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Questions about Website Content Controls

5. Do you publish a website or social media page?

5A. Do you agree to review the guidelines for website content risk management we will send if you bind coverage? These guidelines cover copyright infringement, libel and slander and other content hazards you need to consider

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Questions about Prior Insurance

6. Does the Applicant currently have Cyber protection coverage in place?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

7. Have you ever been non-renewed for Cyber Protection coverage?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Premium Options

Please choose one of the options below.  To review limits and coverage refer back to the Limits Profile and Coverage Highlists page.

This document provides a non legally binding indication of potential pricing, based on the information you have provided within this application. The Company gives no representation, warranty or confirmation of protection being granted. All risks must be agreed by the Company in writing prior to any coverage being granted.

  • If you choose "Yes", please submit this application to the Program Administrator and, if accepted, issue a confirmation of my enrollment and a certificate/policy.
 
  • If you choose "No", you agree to the following:

    I understand that I have a potential exposure to a serious financial loss that is not covered by other types of Insurance.

 

NOTICE TO APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH IS A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO ARKANSAS, NEW MEXICO AND WEST VIRGINIA APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT, OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO COLORADO APPLICANTS: IT IS UNLAWFUL TO KNOWINGLY PROVIDE FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES, DENIAL OF INSURANCE, AND CIVIL DAMAGES. ANY INSURANCE COMPANY OR AGENT OF AN INSURANCE COMPANY WHO KNOWINGLY PROVIDES FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO A POLICYHOLDER OR CLAIMANT FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE POLICYHOLDER OR CLAIMANT WITH REGARD TO A SETTLEMENT OR AWARD PAYABLE FROM INSURANCE PROCEEDS SHALL BE REPORTED TO THE COLORADO DIVISION OF INSURANCE WITHIN THE DEPARTMENT OF REGULATORY AUTHORITIES.

NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: WARNING: IT IS A CRIME TO PROVIDE FALSE OR MISLEADING INFORMATION TO AN INSURER FOR THE PURPOSE OF DEFRAUDING THE INSURER OR ANY OTHER PERSON. PENALTIES INCLUDE IMPRISONMENT AND/OR FINES. IN ADDITION, AN INSURER MAY DENY INSURANCE BENEFITS IF FALSE INFORMATION MATERIALLY RELATED TO A CLAIM WAS PROVIDED BY THE APPLICANT.

NOTICE TO FLORIDA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY IN THE THIRD DEGREE.

NOTICE TO KANSAS APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD, PRESENTS, CAUSES TO BE PRESENTED OR PREPARED WITH KNOWEDLGE OR BELIEF THAT IT WILL BE PRESENTED TO OR BY AN INSURER, PURPORTED INSURER, BROKER OR ANY AGENT THEREOF, ANY WRITTEN STATEMENT AS PART OF, OR IN SUPPORT OF, AN APPLICATION FOR THE ISSUANCE OF, OR THE RATING OF AN INSURANCE POLICY FOR PERSONAL OR COMMERCIAL INSURANCE, OR A CLAIM FOR PAYMENT OR OTHER BENEFIT PURSUANT TO AN INSURANCE POLICY FOR COMMERCIAL OR PERSONAL INSURANCE WHICH SUCH PERSON KNOWS TO CONTAIN MATERIAL FALSE INFORMATION CONCERNING ANY FACT MATERIAL THERETO; OR CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT.

NOTICE TO KENTUCKY APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME.

NOTICE TO LOUISIANA APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO MAINE APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES OR A DENIAL OF INSURANCE BENEFITS.

NOTICE TO MARYLAND APPLICANTS: ANY PERSON WHO KNOWINGLY AND WILLFULLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR WHO KNOWINGLY AND WILLFULLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO MINNESOTA APPLICANTS: A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME.

NOTICE TO NEW JERSEY APPLICANTS: ANY PERSON WHO INCLUDES ANY FALSE OR MISLEADING INFORMATION ON AN APPLICATION FOR AN INSURANCE POLICY IS SUBJECT TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO NEW YORK APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME, AND SHALL ALSO BE SUBJECT TO A CIVIL PENALTY NOT TO EXCEED FIVE THOUSAND DOLLARS AND THE STATED VALUE OF THE CLAIM FOR EACH SUCH VIOLATION.

NOTICE TO OHIO APPLICANTS: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.

NOTICE TO OKLAHOMA APPLICANTS: WARNING: ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO INJURE, DEFRAUD OR DECEIVE ANY INSURER, MAKES ANY CLAIM FOR THE PROCEEDS OF AN INSURANCE POLICY CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY (365:15-1-10, 36 §3613.1).

NOTICE TO OREGON APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH MAY BE A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO PENNSYLVANIA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO TENNESSEE, VIRGINIA AND WASHINGTON APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES AND DENIAL OF INSURANCE BENEFITS.

NOTICE TO VERMONT APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH MAY BE A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

THE UNDERSIGNED IS AUTHORIZED BY THE APPLICANT AND DECLARES THAT THE STATEMENTS SET FORTH HEREIN ARE TRUE. THE UNDERSIGNED AGREES THAT IF THE INFORMATION SUPPLIED ON THIS APPLICATION CHANGES BETWEEN THE DATE OF THIS APPLICATION AND THE EFFECTIVE DATE OF THE PROGRAM AND/OR INSURANCE, HE/SHE WILL, IN ORDER FOR THE INFORMATION TO BE ACCURATE ON THE EFFECTIVE DATE OF THE PROGRAM AND/OR INSURANCE, IMMEDIATELY NOTIFY THE PROGRAM ADMINISTRATOR OR INSURER OF SUCH CHANGES, AND THE PROGRAM ADMINISTRATOR OR INSURER MAY WITHDRAW OR MODIFY ANY OUTSTANDING QUOTATIONS OR AUTHORIZATIONS OR AGREEMENTS TO BIND THE PROGRAM AND/OR INSURANCE.  SIGNING OF THIS APPLICATION DOES NOT BIND THE APPLICANT OR THE INSURER TO COMPLETE THE INSURANCE, BUT IT IS AGREED THAT THIS APPLICATION SHALL BE THE BASIS OF THE CONTRACT SHOULD A POLICY BE ISSUED, AND IT WILL BECOME PART OF THE POLICY.   ALL WRITTEN STATEMENTS AND MATERIALS FURNISHED TO THE INSURER IN CONJUNCTION WITH THIS APPLICATION ARE HEREBY INCORPORATED BY REFERENCE INTO THIS APPLICATION AND MADE A PART HEREOF. THIS APPLICATION IS ATTACHED TO THE POLICY AT THE TIME OF ITS DELIVERY. PROVIDED, HOWEVER, THIS PARAGRAPH DOES NOT APPLY IN THE STATE OF UTAH.  Furthermore, and in respect of additional and related program deliverables, the undersigned declares that he/she understands and agrees to all of the terms and conditions provided in the Customer Agreement located at: http:// biz.identityfraud.com/pages/customer-agreement and to the following statement: In respect of the Data Risk Liability insurance, I acknowledge that the coverage is provided on a "claims made" basis. I also specifically confirm that I will or that I have read, understood and agree to my state insurance disclosure, which relates to Excess and/or Surplus Lines insurance, which in summary, states the insurance company with which the Data Risk Liability coverage is being placed is not licensed by my state and is not subject to its supervision. In the event of insolvency of the insurance company, losses under the policy will not be paid by any state insurance guaranty or insolvency fund. Additionally, the coverage is provided pursuant to my acceptance into and continued active status in the Data Theft Risk Purchasing Group and/or related RPG. I understand there may be a nominal fee of $1.00 per term paid to the RPG from the proceeds of my purchase.

0, 0322