1. My business annual revenue is less than US$10M and is
not within one of the following categories:
Airline and airport operations; Blockchain technology provider; Broadcasting, Film & Production; Business process outsourcing services, Call center services; Credit intermediation, commodities, and securities exchanges; Cryptocurrency activities; Data warehouses; Franchisees/Franchisors; Gambling industries; Government agencies, municipalities, or public bodies; H.R. services; Managed IT services; Marijuana and cannabis related products and services; Mobile applications or Video game development; Mortgage & loan brokers; Payment card processors or gateways; Payroll processing; Pornography, Securities intermediation; Social dating or Professional networking services; Utilities, including water or sewage providers; Healthcare exchanges or clearing houses; Family planning centers or services, Insurance providers; Substance abuse centers or services, Abortion clinics, Hotels / Bed & Breakfast.
Or
2. My business annual revenue is less than US$2M and is within one of the following categories:
- Healthcare clinic with 5 physicians or less, excluding:
- i. Family planning centers or services
- ii. Substance abuse centers or services
- iii. Abortion clinics
- Insurance provider
- Independent Hotel / Bed & Breakfast
3. My business has:
- No known cyber claims/circumstances in the previous 3 years
- No foreign subsidiaries
- Anti-virus, anti-malware software or endpoint security in place
- Patching of software application versions every 30 days
- One offline backup available or full cloud backup. Daily backups preferred.
- Multifactor Authentication (MFA) enabled in all remote access, including cloud services
- Encryption of sensitive data at rest
The above questions constitute an application for insurance. For this application, the applicant is an authorized officer of the organization applying for insurance and declares that the statements above are true, accurate and complete. The insurer is authorized to make any inquiry in connection with this application. The information contained in and submitted with this application is on file with the insurer. The insurer will have relied upon this application and its attachments in issuing the policy. If the information in this application materially changes prior to the effective date of the policy the applicant will promptly notify the insurer, who may modify or withdraw the quotation.
You confirm and agree that:
You, and your insurance broker on your behalf, have given a fair presentation of the risk to be insured by disclosing all material facts and circumstances.
You have provided consent for BOXX Insurance to use your information i) for underwriting purposes, including a cyber security rating through an external, nonintrusive source, ii) to compile aggregate statistical data to be used to monitor trends in the insurance industry, and iii) to comply with regulatory oversight.
You comply with sanctions, prohibition, or restrictions imposed by the Office of Foreign Asset Control, United Nations, Canada, Switzerland, the United Kingdom, and the European Union. You understand that these sanctions prevent us from contracting with companies who are restricted under these Acts.
By entering your name and email, you agree that all information provided to BOXX Insurance to generate this insurance policy is accurate and true. Entering your name and email address is akin to signing any legal document and you will be bound to all acknowledgements provided herein and that you have the authority to bind your company to this agreement.
Notice: This policy you are applying to is written on a claims-made and reported basis. Except as otherwise stated, this policy covers only claims first made against you and incidents or losses first discovered by you during the policy period, or any applicable extended reporting period, and notified to us pursuant to your obligations. The information requested herewith pertains to all persons or entities, including the solicitor company and its subsidiaries. If a policy is issued, this application will attach to and become part of the policy.
Your Cyber Liability Policy is considered a fully earned policy and therefore is non-cancellable. You, as the insured, acknowledge and agree that there will be no return premium and you are responsible for payment in full regardless of the status of the policy. In the event that the Insured fails to pay, Insured agrees that the unpaid balance is subject to additional fees that may accrue including but not limited to late fees, attorney’s fees, and collection fees up to the maximum amount permitted by law.
