Professional Liability (E&O) Quote Request

Professional liability, also called errors and omissions, responds when a client claims your advice or work caused them a financial loss. General liability does not cover this — it only covers physical injury and property damage.

Fill in what you know and leave the rest blank — only your name, email and phone are required. We will come back to you for anything missing. Nothing here is an application and nothing is binding.

Your business Business Name

DBA / Trading AsOnly if different from the name above.Business Structure

Business Address

CityZIP Code

Mailing AddressOnly if your mail goes somewhere else.

Your First NameYour Last Name

Email AddressPhone Number

Years in BusinessApproximate Annual RevenueA rough figure is fine.

WebsiteIf you have one.

The services you provide Describe the Professional Services You Provide

Years Providing These ServicesHow Many People Provide Them?Owners plus staff.

Do You Work Under Written Contracts?Do Your Contracts Cap Your Liability?A clause limiting what a client can recover from you. Check your standard contract.

Any Work You Subcontract to Others?

The cover you want

Cover Limits You WantPer claim and total for the year.Retroactive DateHow far back you need cover for work already done. Write 'full prior acts' if you want it all covered.

Deductible You Are Comfortable With

Claims

Are You Aware of Anything That Could Turn Into a Claim?

If Yes, Please Describe

Your current cover and timing Any claims or disciplinary actions in the past 5 years?

Current or Previous InsurerIf you are switching or renewing.What You Pay NowIf you know it.

When Do You Need Cover to Start?

Anything Else We Should Know

This is a solicitation for insurance. Completing this form does not apply for or bind cover. Coverage cannot be bound or changed via this form, e-mail, voicemail, text, or facsimile — only by written confirmation from our office.

Would you rather fill it in on paper?

Download the same questions as a printable form, or as a Word file you can type into, and bring it in or send it back to us.

PDF version · Word version · All quote request forms

Would you rather fill it in on paper?

Rather just talk it through?