Any company that provides a service to others in exchange for a fee faces a potential professional liability exposure. Errors & Omissions (E&O) coverage provides insurance protection for entities being sued by their clients over such allegations as:
Errors, omissions, or negligence related
to the provision of a service
Failure to provide a service
Unprofessional conduct
Improper documentation
Mismanagement
Misrepresentation of facts
Non-disclosure of information
The financial impact of an E&O suit on a company can be devastating and can potentially wipe out corporate and personal assets. Even if the allegations are proven to be groundless, the firm would still incur substantial legal defense costs.
Fox Point Programs is here to help! The information below will allow our underwriters to contact you with coverage information about your risk. Additional information may be necessary to provide a premium indication.
Section 1 - General Information
Insureds Name:
Who Should Fox Point Contact:
E-mail:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Website:
Profession:
Description of Services:
Annual Income This Year: $
Section 2 - Current Insurance Coverage
Effective Date:
Retro Date:
Insurance Carrier
Limits: $
Deductible: $
Premium: $
Section 3 - Prior Experience
Has any prior E&O insurance policy been cancelled or non-renewed?
Yes
No
Have you had any E&O claims in the past five years, or have knowledge or information of any act, error, or omission which might reasonably be expected to give rise to a claim?
Yes
No
Please provide details if you answered "Yes" to either question above.
If you are a sub-producer, please complete the information below.
Section 4 - Sub-Producer
Agent Name:
Agency Name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail: