Premium Financing Available.

NOTICEThis instant indication is for agencies with 80% personal lines business. Quick indications are still available by clicking the "apply now" button above. Please complete the quick app and an indication willl be faxed or emailed to you within 24 hours. As a Select agent, additional credits may apply. Limits up to 5 million are available by application only. 

Your Full Name:
Phone Number:
Fax Number:
Email Address:
Is agency owned or controlled by or associated with any other business entity?
Is agency currently insured with XL, USE&O, Greenwich, Indian Harbor, US Brokers Network (USBN)?
Please provide your desired E&O coverage information:
Select your desired limits:
Select your desired deductible:
How many consecutive years has the applicant's primary broker been licensed to sell insurance?*
What is your agency's annual revenue for the past 12 months?*
*Revenue is considered your total commission income for all policies sold on a retail basis,plus the net retained commission for all policies sold on a sub-produced or wholesale basis (if applicable).
What is the percentage of business placed as a wholesaler (business placed for other agents)?*%
*Wholesale business is the placement of business on behalf of an outside retail agency (sub-producer).
Typically a wholesaler has direct access to various carriers, and the sub-producer (retail agent) utilizes
a wholesaler to access such carriers.
What is the percentage of business placed as an MGA (business for which you have underwriting authority)?*%
*MGA activities usually involve underwriting and/or binding authority on behalf of a specific insurance carrier.
What percentage of your business is Personal Lines (Auto, Property & Dwelling - no Life Accident & Health)?*%
*For the purpose of the above question, please include all personal auto, homeowner's insurance,personal umbrella, etc., but DO NOT include any Life Accident Health coverage.
What is the highest percentage of business you place in any ONE of the following areas:Professional Liability, Medical Malpractice, Aviation/Wet Marine, Bonds, and Trucking (Long Haul and/or Fleet)?*%
*For example, if you handle 10% Professional Liability, 2% Medical Malpractice, and 7% Wet Marine, yourresponse to the above question would be 10% as it is the highest percentage of business placed in any
ONE of the areas specified.
Have you had any claims or disciplinary actions within the past 5 years?
*A claim in this case is any incident which caused you or your insurance carrier to pay any indemnity or
expense costs. Open incidents with any indemnity reserves or expense reserves are also considered claims.
Does your agency have an Automated Diary/Management System?*An automated diary/management system is any computerized system used to track important dates,deadlines, and pending items for follow-up and appropriate handling.
What percentage of your business is placed on a direct bill basis?%
*Direct billed business is business fo which the insurance carrier (not the applicant) handles the billing
policy renewals and/or payment plans.