Forms & Applications

Below are links to specimen policies, applications and supplements categorized by product.

Please direct all submissions here

Media Liability

Film & Entertainment - Product Application

Admitted

Film & Entertainment Producer Liability Application for Insurance
Film & Entertainment Acquisition & Development, Distributor, and Film Library Application
Film & Entertainment Acquisition & Development, Distributor, and Film Library Liability Renewal Application
Data & Privacy Protection Coverage Application

New York Free Trade Zone

Film & Entertainment Producer Liability Application for Insurance
Film & Entertainment Acquisition & Development, Distributor, and Film Library Application
Film & Entertainment Acquisition & Development, Distributor, and Film Library Renewal Application
Data & Privacy Protection Coverage Application

Non-Admitted (AK, LA, PR, VT and WY)

Film & Entertainment Producer Liability Application for Insurance
Film & Entertainment Acquisition & Development, Distributor, and Film Library Application
Film & Entertainment Acquisition & Development, Distributor, and Film Library Liability Renewal Application
Data & Privacy Protection Coverage Application

State-Specific

Florida Application Cover Page
Massachusetts Application Cover Page
Film & Entertainment Producer Liability Application for Insurance (Florida)
Film & Entertainment Producer Liability Application for Insurance (Montana)
Film & Entertainment Producer Liability Application for Insurance (New Hampshire)
Film & Entertainment Producer Liability Application for Insurance (Oklahoma)
Film & Entertainment Acquisition & Development, Distributor, and Film Library Liability Application (New Hampshire)
Film & Entertainment Acquisition & Development, Distributor, and Film Library Liability Renewal Application (New Hampshire)
Film & Entertainment Acquisition & Development, Distributor, and Film Library Liability Renewal Application (Florida)
Data & Privacy Protection Coverage Application (New Hampshire)
Data & Privacy Protection Coverage Application (Oklahoma)


Film & Entertainment - Specimen Policies

Admitted

Film & Entertainment Liability Policy FE003 - Occurrence Policy Form, Defense Within Limit
Film & Entertainment Liability Policy FEC004 - Claims Made Policy Form, Defense Within Limit

New York Free Trade Zone

Film & Entertainment Liability Policy FE003 - Occurrence Policy Form, Defense Within Limit
Film & Entertainment Liability Policy FEC004 - Claims Made Policy Form, Defense Within Limit

Non-Admitted (AK, LA, PR, VT and WY)

Film & Entertainment Liability Policy FE003 - Occurrence Policy Form, Defense Within Limit
Film & Entertainment Liability Policy FEC004 - Claims Made Policy Form, Defense Within Limit

Film & Entertainment - Supplements

Admitted

Film & Entertainment Producer Liability Supplemental Questionnaire
Film & Entertainment Reality Television Supplement
Media-Cyber Liability Supplement

New York Free Trade Zone

Film & Entertainment Producer Liability Supplemental Questionnaire
Film & Entertainment Reality Television Supplement
Media-Cyber Liability Supplement

Non-Admitted (AK, LA, PR, VT and WY)

Film & Entertainment Producer Liability Supplemental Questionnaire
Film & Entertainment Reality Television Supplement
Media-Cyber Liability Supplement

State-Specific

Film & Entertainment Producer Liability Supplemental Questionnaire (New Hampshire)
Film & Entertainment Reality Television Supplement (New Hampshire)
Media-Cyber Liability Supplement (New Hampshire)

Multimedia - Product Applications

Admitted

Multimedia Liability Coverage Application
Multimedia Liability Coverage Renewal Application
Data & Privacy Protection Coverage Application

New York Free Trade Zone

Multimedia Liability Coverage Application
Multimedia Liability Coverage Renewal Application
Data & Privacy Protection Coverage Application

Non-Admitted (AK, LA, PR)

Multimedia Liability Coverage Application
Multimedia Liability Coverage Renewal Application
Data & Privacy Protection Coverage Application

State-Specific

Florida Application Cover Page
Massachusetts Application Cover Page
Multimedia Liability Coverage Application (New Hampshire)
Multimedia Liability Coverage Renewal Application (New Hampshire)
Multimedia Liability Coverage Renewal Application (Florida)
Data & Privacy Protection Coverage Application (New Hampshire)
Data & Privacy Protection Coverage Application (Oklahoma)

Multimedia - Specimen Policies

Admitted

Multimedia Liability Policy MM001 - Occurrence Policy Form, Defense Within Limit
Multimedia Liability Policy - MM002 - Occurrence Policy Form, Defense In Addition to Limit
Multimedia Liability Policy MMC005 - Claims Made Policy Form, Defense Within Limit

New York Free Trade Zone

Multimedia Liability Policy MM001 - Occurrence Policy Form, Defense Within Limit
Multimedia Liability Policy - MM002 - Occurrence Policy Form, Defense In Addition to Limit
Multimedia Liability Policy MMC005 - Claims Made Policy Form, Defense Within Limit

Non-Admitted (AK, LA, PR)

Multimedia Liability Policy MM001 - Occurrence Policy Form, Defense Within Limit
Multimedia Liability Policy - MM002 - Occurrence Policy Form, Defense In Addition to Limit
Multimedia Liability Policy MMC005 - Claims Made Policy Form, Defense Within Limit

Multimedia - Supplements

Admitted

Media-Cyber Liability Supplement

New York Free Trade Zone

Media-Cyber Liability Supplement

Non-Admitted (AK, LA, PR)

Media-Cyber Liability Supplement

State-Specific

Media-Cyber Liability Supplement (New Hampshire)

MPL Solutions

Product Applications

Admitted

MPL Solutions Application
MPL Solutions Renewal Application

Non-Admitted

Miscellaneous Professional Liability Application
Miscellaneous Professional Liability Renewal Application
Miscellaneous Professional Liability-TechNet Solutions Errors & Omissions Renewal Application

State-Specific

Massachusetts Application Cover Page
MPL Solutions Application (Maine, Texas, Washington)
MPL Solutions Renewal Application (Maine, Texas, Washington)
MPL Solutions Application (New Hampshire)
MPL Solutions Renewal Application (New Hampshire)
MPL Solutions Application (Florida)
MPL Solutions Renewal Application (Florida)

Specimen Policies

Admitted

MPL Solutions Insurance Policy MPL

Non-Admitted

Miscellaneous Professional Liability Insurance Policy

Supplements

Admitted

MPL Solutions - Association Management Company Supplement
MPL Solutions - Claims Adjuster Supplement
MPL Solutions - Computer Technology Supplement
MPL Solutions - Educational Seminar Instructor Supplement
MPL Solutions - Employment Agency-Executive Search Supplement
MPL Solutions - Freight Forwarders-Customs Brokers Supplement
MPL Solutions - Graphic Designer Supplement
MPL Solutions - Interior Design-Decoration Supplement
MPL Solutions - Management Consulting Supplement
MPL Solutions - Mid-Term Acquisition, Merger or Newly Created Entity Questionnaire
MPL Solutions - Mid-Term Change of Name Due to Acquisition or Merger Questionnaire
MPL Solutions - Mortgage Brokers-Mortgage Bankers Supplement
MPL Solutions - Network Security Supplement
MPL Solutions - Notary Public Supplement
MPL Solutions - Online Internet Related Services Supplement
MPL Solutions - Premium Finance Company Supplement
MPL Solutions - Printers Supplement
MPL Solutions - Public Record Search Supplement
MPL Solutions - Public Relations-Promotion-Marketing Firms Supplement
MPL Solutions - Real Estate Operations Supplement
MPL Solutions - RESPA Questionnaire
MPL Solutions - Standards Organizations Supplement
MPL Solutions - Third Party Administrators-Review Boards Supplement
MPL Solutions - Travel Agency-Tour Operator Supplement
MPL Solutions - User-Generated Content Supplement

Non-Admitted

Association Management Company Supplement
Claims Adjuster Supplement
Clinical Labs-Testing Labs Supplement
Computer Technology Supplement
Educational Seminar Instructor Supplement
Employment Agency-Executive Search Supplement
Freight Forwarders-Customs Brokers Supplement
Graphic Designer Supplement
Interior Design-Decoration Supplement
Management Consulting Supplement
Mid-Term Acquisition-Merger-Newly Created Entity Questionnaire
Mid-Term Change of Name Due to Acquisition-Merger Questionnaire
Mortgage Brokers-Mortgage Bankers Supplement
Notary Public Supplement
Online Internet Related Services Supplement
Premium Finance Company Supplement
Printers Supplement
Public Record Search Supplement
Public Relations-Promotion-Marketing Firms Supplement
Real Estate Operations Supplement
RESPA Questionnaire
Standards Organizations Supplement
Third Party Administrators-Review Boards Supplement
Travel Agency-Tour Operator Supplement

Privasure™

Product Applications

Non-Admitted

PrivaSure™ Application

Specimen Policies

Non-Admitted

PrivaSure™ Insurance Policy

Association Programs

American Association of Advertising Agencies (4A) - Product Applications

Admitted

4A Application

New York Free Trade Zone

Advertising Agency Liability Application

Non-Admitted (AK, LA, OK and PR - VT and WY for Defense within Limits coverage)

4A Application

State-Specific

Massachusetts Application Cover Page
4A Application (Florida)

American Association of Advertising Agencies (4A) - Specimen Policies

Admitted

4A Multimedia Liability Policy - Claim Expense Within the Limit
4A Multimedia Liability Policy - Claim Expense Outside the Limit

New York Free Trade Zone

Advertising Agency Liability Policy - Claim Expense Within the Limit
Advertising Agency Liability Policy - Claim Expense Outside the Limit

Non-Admitted (AK, LA, OK and PR - VT and WY for Defense within Limits coverage)

4A Multimedia Liability Policy - Claim Expense Within the Limit
4A Multimedia Liability Policy - Claim Expense Outside the Limit

American Society of Association Executives (ASAE) - Product Applications

Non-Admitted

ASAE Application
ASAE Renewal Application

American Society of Association Executives (ASAE) -Specimen Policies

Non-Admitted

ASAE Insurance Policy

American Society of Association Executives (ASAE) - Supplements

Non-Admitted

Affiliate Organization Supplement
Certification-Accreditation Supplement
Consulting Services Supplement
Subsidiary Organizations Supplement
Technology Services Supplement

National Association of Broadcasters (NAB) - Product Applications

Admitted

NAB Application
NAB Data and Privacy Protection Coverage Application

New York Free Trade Zone

Broadcasters Liability Application
Broadcasters Liability Cyberliability Supplement
Broadcasters Liability Data and Privacy Protection Coverage Application

Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)

NAB Application
NAB Data and Privacy Protection Coverage Application

State-Specific

Massachusetts Application Cover Page
North Carolina Application Cover Page
NAB Application (Florida)
NAB Application (Montana)
NAB Application (New Hampshire)
NAB Data and Privacy Protection Coverage Application (Florida)

National Association of Broadcasters (NAB) - Specimen Policies

Admitted

NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit

New York Free Trade Zone

NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit

Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)

NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit

National Association of Broadcasters (NAB) - Supplements

Admitted

Cyberliability Supplement

New York Free Trade Zone

Cyberliability Supplement

Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)

Cyberliability Supplement

State-Specific

Cyberliability Supplement (Florida)
Cyberliability Supplement (Montana)
Cyberliability Supplement (New Hampshire)

National Association of Television and Program Executives (NATPE) - Product Applications

Admitted

NATPE Acquisition & Development, Distributor, and Film Library Liability Application
NATPE Producer Liability Application

State-Specific

NATPE Acquisition & Development, Distributor, and Film Library Liability Application (New Hampshire)
NATPE Producer Liability Application (New Hampshire)

Healthcare Billing & Management Association (HBMA) - Product Applications

Non-Admitted

HBMA Application
HBMA Renewal Application