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Cyber Liability - Quote Request form
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Name
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First
Last
Do you back up your data at least once a week and store in an offsite location?
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Yes
No
Email
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Do you have antivirus and firewalls in place that are updated at least quarterly?
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Yes
No
Phone Number
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Is personally idenfifiable information stored on laptop computers and portable media (flash drives, back-up tapes) protected by encryption?
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Yes
No
Address
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Line 1
Line 2
City
State
Zip Code
Country
Website
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I am interested in adding Cyber Deception extension to my quote.
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Yes
No
Have you previously purchased a Cyber Policy?
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Yes
No
Are you aware of any circumstances which might give rise to a claim?
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Yes
No
Within the last 5 years, have you suffered any system intrusions, tampering, virus or malicious code attack, loss of data , loss of portable media, hacking incident, extortion attempts, data theft or similar, situations.
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Yes
No
Cyber Deception extension provides coverage for the intentional misleading of the insured by means of a dishonest misrepresentation of a material fact contained or conveyed within an electronic or telephonic communication(s) and which is relied upon by the insured believing it to be genuine. Commonly know as "spear-phishing" or "social engineering".
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