Life Insurance Agents E&O Application

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Thank you for applying for life insurance agent/agency professional liability coverage (including coverage for Kai-Zen premium financing) sponsored by NIW Companies, Inc. and underwritten by the National Casualty Company. The Financial Services Professional Liability Purchasing Group, of which you will become a member, is managed by ProSurance Group, Inc. Lockton Affinity acts as the program administrator and agent for this program.

This is a claims made and reported policy that provides the following limits and retentions:

  • Limits

  • $1,000,000 per wrongful act limit.

  • $3,000,000 annual agent aggregate limit.

  • $10,000,000 annual policy aggregate for all insureds.

  • Retentions (deductibles)

  • $1,000 for claims solely arising from fixed insurance (other than indexed insurance) and fixed annuities.

  • $5,000 for claims involving indexed life and/or indexed annuities.

  • $10,000 for claims involving mutual funds and/or variable products.

  • $15,000 for claims involving Kai-Zen premium financing.

  • Certain exclusions apply to the coverage. Click for a sample policy.

  • Coverage Options:

  • Applicant may apply as an individual or as an agency. Individual coverage will insure the individual and his/her firm’s vicarious liability arising out of his/her acts. Agency coverage will insure the agency itself and all employed and independent contractor individuals for their acts through the agency.

  • The undersigned, hereinafter referred to as Applicant (which includes the individual and his/her firm or the agency applying for coverage and the agency’s employees and independent contractors), hereby makes application for claims made and reported professional liability Insurance coverage, and in connection therewith furnishes National Casualty Company (“the Company”) the following information:

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Applicant Information
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· zip format (i.e. 11767) or zip+4 (i.e. 11767-2345)
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. phone format (444-333-2222)
. phone format (444-333-2222)
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